Microsurgical anatomy of the cavernous sinus

The cavernous sinus is a venous confluence encased by dural layers and located on the medial aspect of the middle cranial fossa and lateral to the sellar region. It has several venous tributaries that connect to it. It predominantly drains through the petrosal sinuses to the jugular system. The neural elements of the cavernous sinus include the oculomotor nerve, the trochlear nerve, the trigeminal nerve and the abducens nerve. The arterial anatomy is comprised mainly of the intracavernous portion of the internal carotid and the different branches arising from it including the meningohypophyseal trunk and the inferolateral trunk. Understanding the relationship of the different neural and vascular structures of the cavernous sinus will help in planning safe surgery in its vicinity.