Microsurgical anatomy of the vein of Labbé

Abstract

Venous drainage of the temporal lobe is of great importance in various neurosurgical and combined skull base approaches. The most significant draining vein of the temporal lobe is the inferior anastomotic vein (vein of Labbé). The purpose of this study was to examine the detailed anatomy and variations of the vein of Labbé (VL) from microsurgical perspective. Fourteen fixed human cadaver heads (28 sides) with perfused vessels were included to define microsurgical anatomy and variations of the VL. The main findings of the present study were as follows: (1) drainage pattern of the VL was found to be very variable in cadaveric dissections; (2) VL drained around the sinus confluence at the tentorium in one specimen (3.5%), into the large meningeal vein in the occipital dura mater in another specimen (3.5%). The VL rarely (7%) drains into the superior petrosal sinus (SPS) which may make combined skull base approaches very difficult or impossible. Results of this study suggest that careful and thorough evaluation of the VL is of great importance, especially in surgeries combining a subtemporal route with petrosal approaches by sectioning the SPS and the tentorium.