Abstract
There are multiple anatomical triangles of the skull base. However, to our knowledge, there has been no comprehensive review of these geometric landmarks. To allow for a safe and consistent approach to lesions of the skull base such as those near the internal carotid artery, internal acoustic meatus, and cavernous sinus, a comprehensive review of the variations with illustrations is required. This article provides an overview of the anatomical borders, dimensions, and surgical implications as well as illustrations of the major skull base triangles.
Highlights
BackgroundOwing to its location and formidable anatomical structures, the skull base is a technically difficult region for neurosurgeons, and many surgical approaches to this area have yet to be perfected
This article provides an overview of the anatomical borders, dimensions, and surgical implications as well as illustrations of the major skull base triangles
Parkinson first described a triangle in the lateral wall of the cavernous sinus in the mid-1960s' [1,2]
Summary
Owing to its location and formidable anatomical structures, the skull base is a technically difficult region for neurosurgeons, and many surgical approaches to this area have yet to be perfected. Day and Fukushima described the anterior triangle as defined by the lateral border of the optic nerve, the medial wall of the superior orbital fissure dura, and the dural ring surrounding the internal carotid artery (ICA) as it enters the subarachnoid space. The inferomedial space extends into the posterior cavernous sinus wall and drilling the medial part of this space exposes the lateral edge of the dorsum sellae, petroclival fissure, and Dorello’s canal This triangle contains the abducens nerve, posterior genu of the ICA, the dorsal meningeal branch of the meningohypophysial trunk, basilar venous plexus and overlying dura, posterior petroclinoid fold and Gruber’s petrosphenoid ligament. In the second area in the sagittal plane, Area S II, are the posterior wall of the cavernous sinus and the posterior edge of the petrosal bone starting from the posterior clinoid process to the internal acoustic canal This area contains the inferomedial and inferolateral triangles
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