Microsurgical Anatomy of the Cavernous Sinus: Cadaveric Dissection and Surgical Perspectives

The cavernous sinus remains one of the most anatomically complex and surgically challenging regions of the skull base because of its intimate relationships with the internal carotid artery and multiple cranial nerves. Detailed microsurgical anatomical knowledge is essential for safe skull base and parasellar surgery. A stepwise microsurgical cadaveric dissection of the cavernous sinus was performed on six adult formalinfixed specimens using a standard pterional extradural approach under magnification with a Leica operating microscope. Progressive extradural and interdural dissections were carried out to expose the lateral wall of the cavernous sinus, cranial nerves III, IV, V1, V2, and VI, the intracavernous internal carotid artery, and the principal surgical triangles of the cavernous sinus. The dissection demonstrated the multilayered interdural architecture of the lateral wall and allowed identification of the interdural cleavage plane extending from the superior orbital fissure to Meckel’s cave. Cranial nerves III, IV, V1, and V2 were identified within the lateral wall, whereas the abducens nerve coursed medially within the venous compartment adjacent to the cavernous internal carotid artery. Parkinson’s triangle and the anteromedial and infratrochlear corridors provided useful operative windows to the intracavernous compartment. Stepwise cadaveric dissection remains an effective educational tool for understanding the microsurgical anatomy of the cavernous sinus and improving operative orientation during skull base procedures.