ORIGINAL
O seio cavernoso é uma das regiões mais complexas do corpo
humano e pode ser acometido por diversas patologias. Atualmente,
diversos tipos de tratamento podem ser usados para
tratar doenças nesta região, porém o conhecimento anatômico
ainda é fundamental para estabelecer o melhor manejo. Nosso
objetivo é apresentar a anatomia microcirúrgica do seio cavernoso,
as abordagens cirúrgicas (incluindo a abordagem endonasal
endoscópica), a correlação radiológica desta anatomia,
bem como uma série inicial de casos. As fotos são apresentadas
pelo método convencional e anaglífico estereoscópico. São
descritas as estruturas neurovasculares do seio cavernoso bem
como suas relações ósseas e durais, as paredes e os triângulos
da base do crânio relacionados ao seio cavernoso. As abordagens
crânio-órbito zigomática, transpetrosa, zigomática e
endonasal endoscópica são apresentadas, sendo as estruturas
anatômicas identificadas também nos exames de imagem. Casos
ilustrativos ilustram esta anatomia.
The cavernous sinus is one of the most complex regions of the
human body and can be affected by several diseases. Currently,
several types of treatment can be used in the management of
diseases in this region. The anatomical knowledge is essential
to establish the best management. Our goal is to present the
microsurgical anatomy of the cavernous sinus, its surgical approaches
(including the endoscopic endonasal approach), the
correlation of radiological anatomy, including an initial series
of cases. The anatomic features are presented by the conventional
and stereoscopic anaglyphic method. The neurovascular
structures of the cavernous sinus and its dural and bony relationships,
triangles and the walls of the skull base related to
it are presented with. We discuss the cranio-orbital zygomatic,
transpetrosal, zygomatic and endonasal endoscopic approaches;
MRI studies also show the anatomical structures, including
illustrative cases.
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1. Serviço de Neurologia e Neurocirurgia (Núcleo de Cirurgia da Base do Crânio) do Hospital Moinhos de Vento, Porto Alegre.
2. Serviço de Neuroimagem do Hospital Moinhos de Vento, Porto Alegre
3. Serviço de Neurologia (Unidade de Neurocirurgia) do Hospital de Clínicas de Porto Alegre.
4. Centro de Neurologia e Neurocirurgia Centenário, São Leopoldo, RS
5. Programa de Pós-Graduação em Medicina: Ciências Cirúrgicas da Universidade Federal do Rio Grande do Sul (UFRGS)
6. Acadêmico de Medicina PUC-PR
7. Acadêmico de Medicina UFRGS
Recebido em novembro de 2010, aceito em dezembro de 2010
