Surgical considerations about the anterior syphon knee of the internal carotid artery

Meneses, Murilo S.; Molinari, Danielle; Fortes, Marcia; Rangel, Patricia; Neves, Tatiana; Pedroso, Ari; Ramina, Ricardo

doi:10.1590/S0004-282X1995000100006

Abstracts

An anatomical study about the anterior knee of the intracavernous carotid artery is presented. Twenty cavernous sinuses (CS) were dissected in cadavers using microsurgical techniques. A fibrous ring around the internal carotid artery (ICA) at the CS roof was found in all specimens. This fibrous attachment could be dissected from the surrounding dura and a loose connective tissue could be demonstrated around the ICA. This anatomical finding makes possible the microsurgical approach to vascular lesions of this portion of the ICA, without opening the cavernous sinus.

surgical anatomy; infraclinoidal carotid artery; cavernous sinus; fibrous ring

Apresentamos um estudo anatômico sobre o joelho anterior da porção intracavernosa da artéria carótida interna (ACI). Foram dissecados vinte seios cavernosos de cadáveres utilizando técnicas microcirúrgicas. Um anel fibroso em volta da ACI na parte superior do seio cavernoso foi encontrado em todos os casos. Esta fixação fibrosa pode ser dissecada da dura mater e um tecido conectivo frouxo pode ser visualizado em volta da ACI. Este achado anatômico possibilita o acesso microcirúrgico às lesões vasculares desta porção da ACI, sem abrir o seio cavernoso.

anatomia cirúrgica; artéria carótida (porção infraclinóidea); seio cavernoso; anel fibroso

Surgical considerations about the anterior syphon knee of the internal carotid artery. An anatomical study

Considerações cirúrgicas sobre o joelho anterior do sifão da artéria carótida interna: estudo anatômico

Murilo S. Meneses^{I, II}; Danielle Molinari^I; Marcia Fortes^I; Patricia Rangel^I; Tatiana Neves^I; Ari Pedroso^II; Ricardo Ramina^II

^IDepartment of Anatomy, Federal University of Parana

^IIDepartment of Neurosurgery, Curitiba Skull Base Foundation, Curitiba, Brazil

SUMMARY

An anatomical study about the anterior knee of the intracavernous carotid artery is presented. Twenty cavernous sinuses (CS) were dissected in cadavers using microsurgical techniques. A fibrous ring around the internal carotid artery (ICA) at the CS roof was found in all specimens. This fibrous attachment could be dissected from the surrounding dura and a loose connective tissue could be demonstrated around the ICA. This anatomical finding makes possible the microsurgical approach to vascular lesions of this portion of the ICA, without opening the cavernous sinus.

Key words: surgical anatomy, infraclinoidal carotid artery, cavernous sinus, fibrous ring.

RESUMO

Apresentamos um estudo anatômico sobre o joelho anterior da porção intracavernosa da artéria carótida interna (ACI). Foram dissecados vinte seios cavernosos de cadáveres utilizando técnicas microcirúrgicas. Um anel fibroso em volta da ACI na parte superior do seio cavernoso foi encontrado em todos os casos. Esta fixação fibrosa pode ser dissecada da dura mater e um tecido conectivo frouxo pode ser visualizado em volta da ACI. Este achado anatômico possibilita o acesso microcirúrgico às lesões vasculares desta porção da ACI, sem abrir o seio cavernoso.

Palavras-chave: anatomia cirúrgica, artéria carótida (porção infraclinóidea), seio cavernoso, anel fibroso.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 9-julho-1994.

Dr. Murilo S. Meneses - Avenida Getúlio Vargas 2159 - 80250-180 Curitiba PR - Brasil.

1. AI-Mefty O, Khalil N, Elwany MN. Smith RR. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study. Neurosurgery 1990, 27: 721-728.
2. Diaz FG, Ohaegbulam S, Dujovny M, Ausman JI. Surgical alternatives in the treatment of cavernous sinus aneurysms. J Neurosurg 1989, 71: 846-856.
3. Dolenc V. Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 1983, 58: 824-831.
4. Inoue T, Rhoton AL Jr, Theele D, Barry ME. Surgical approaches to the cavernous sinus: a microsurgical study. Neurosurgery 1990, 26: 903-932.
5. Knosp E, Muller G, Perneczky A. The paraclinoid carotid artery: anatomical aspects of a microsurgical approach. Neurosurgery 1988, 22: 896-901.
6. Kobayashi S, Kyoshima K, Gibo H, Hegde SA, Takemae T, Sugita K. Carotid cave aneurysms of the internal carotid artery. J Neurosurg 1989, 70: 216-221.
7. Linskey ME, Sekhar LN, Hirsch WL Jr, Yonas H, Horton JA. Aneurysms of the intracavernous carotid artery: natural history and indications for treatment. Neurosurgery 1990, 26: 933-938.
8. Ohmoto T, Nagao S, Mino S, Ito T, Honma Y, Fujiwara T. Exposure of the intracavernous carotid artery in aneurysm surgery. Neurosurgery 1991, 28: 317-324.
9. Perneczky A, Knosp E, Manila Ch. Cavernous sinus surgery: approach through the lateral wall. Acta Neurochir (Wien) 1988, 92: 76-82.
10. Perneczky A, Knosp E, Vorkapic P, Czech T. Direct surgical approach to infraclinoidal aneurysms. Acta Neurochir (Wien) 1985, 76: 36-44.
11. Perneczky A, Knosp E, Zohdi A. Surgery of vascular lesions in the cavernous sinus. In: Samii M (ed) Surgery of the sellar region and paranasal sinuses. Berlim: Springer-Verlag, 1991, p 494-501.
12. Sekhar LN, Moller AR. Operative management of tumors involving the cavernous sinus. J Neurosurg 1986, 64: 879-889.
13. Umansky F, Nathan H. The lateral wall of the cavernous sinus with special reference to the nerves related to it. J Neurosurg 1982, 56: 228-234.

Publication Dates

Publication in this collection
19 Jan 2011
Date of issue
Mar 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AI-Mefty O, Khalil N, Elwany MN. Smith RR. Shunt for bypass graft of the cavernous carotid artery: an anatomical and technical study. Neurosurgery 1990, 27: 721-728.

[2] 2. Diaz FG, Ohaegbulam S, Dujovny M, Ausman JI. Surgical alternatives in the treatment of cavernous sinus aneurysms. J Neurosurg 1989, 71: 846-856.

[3] 3. Dolenc V. Direct microsurgical repair of intracavernous vascular lesions. J Neurosurg 1983, 58: 824-831.

[4] 4. Inoue T, Rhoton AL Jr, Theele D, Barry ME. Surgical approaches to the cavernous sinus: a microsurgical study. Neurosurgery 1990, 26: 903-932.

[5] 5. Knosp E, Muller G, Perneczky A. The paraclinoid carotid artery: anatomical aspects of a microsurgical approach. Neurosurgery 1988, 22: 896-901.

[6] 6. Kobayashi S, Kyoshima K, Gibo H, Hegde SA, Takemae T, Sugita K. Carotid cave aneurysms of the internal carotid artery. J Neurosurg 1989, 70: 216-221.

[7] 7. Linskey ME, Sekhar LN, Hirsch WL Jr, Yonas H, Horton JA. Aneurysms of the intracavernous carotid artery: natural history and indications for treatment. Neurosurgery 1990, 26: 933-938.

[8] 8. Ohmoto T, Nagao S, Mino S, Ito T, Honma Y, Fujiwara T. Exposure of the intracavernous carotid artery in aneurysm surgery. Neurosurgery 1991, 28: 317-324.

[9] 9. Perneczky A, Knosp E, Manila Ch. Cavernous sinus surgery: approach through the lateral wall. Acta Neurochir (Wien) 1988, 92: 76-82.

[10] 10. Perneczky A, Knosp E, Vorkapic P, Czech T. Direct surgical approach to infraclinoidal aneurysms. Acta Neurochir (Wien) 1985, 76: 36-44.

[11] 11. Perneczky A, Knosp E, Zohdi A. Surgery of vascular lesions in the cavernous sinus. In: Samii M (ed) Surgery of the sellar region and paranasal sinuses. Berlim: Springer-Verlag, 1991, p 494-501.

[12] 12. Sekhar LN, Moller AR. Operative management of tumors involving the cavernous sinus. J Neurosurg 1986, 64: 879-889.

[13] 13. Umansky F, Nathan H. The lateral wall of the cavernous sinus with special reference to the nerves related to it. J Neurosurg 1982, 56: 228-234.