[Lateral approach to the cavernous sinus and its surroundings--analysis of surgical technique based on cadaver simulations].

BACKGROUND AND PURPOSE: The paper aims to present individual stages of a surgical approach to the cavernous sinus (CS) and its surroundings. MATERIAL AND METHODS: Twelve simulations of a surgical approach to the CS and its surroundings were performed in non-fixed cadavers. The subsequent stages of simulation were recorded in photographs and drawings. RESULTS: The starting point for the approach to the CS is a pterional craniotomy, as well as an osteotomy encompassing the anterior clinoid process and the surroundings of the superior orbital fissure, the optic canal, the foramen rotundum and the foramen ovale. The important phases of the approach include the delamination of the lateral CS wall and the mobilization of the dural rings of the internal carotid artery. Opening of the CS should be preceded with establishing proximal and distal control over the internal carotid artery. CONCLUSIONS: The surgical approach to the CS and its surroundings constitutes a repeatable method of penetration in this area of the cranial base, and it allows for limiting brain traction and preserving the anatomical integrity of the related vessel and nerve structures.