Introduction: The cavernous sinus (CS) is a very important concept because it is not only interesting to anatomical theory but also useful to clinical medicine, especially in the field of surgery. This paper described the microsurgical anatomy of the CS with special attention to its concept that the CS was really venous sinus or plexus. Materials and Methods: Fifty CSs from 25 Chinese adult cadaver heads fixed in 10% methanal, whose artery and vein were injected with red and blue latex, respectively, dissected stepwise under the operating microscope. Results: Asymmetric and nonintegral blue latex distributed in the cavity of the CS to form a retina with various diameters and repeatedly diverged and converged were observed under the surgical microscope with magnification 5 - 25, after the lateral wall of the CS was opened by maxillary approach. Measurement of sinus included length, diameter and triangular structure of the CS. It is very important to understand the microsurgical anatomy of the CS for neurosurgeons. Conclusion: The CS was venous plexus rather than sinus. The lateral wall of the sinus had two layers, and the lateral cavity of the sinus really did exist even though it was very small. The triangles where maxillary approach passed were more important for neurosurgeons.
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