Cavernous Sinus and Middle Fossa Triangles

Common Name Additional Names Borders or Apices Contents Surgical Utility

Oculomotor Triangle Medial triangle,  Anterior clinoid  CN III Corridor to cavernous ICA,
Hakuba triangle  Posterior clinoid  Horizontal segment of ICA intracavernous lesions; posterior roof
 Petrous apex of the cavernous sinus

Clinoidal Triangle Dolenc’s triangle,  CN II  Anterior clinoid process Exposed by removal of the anterior
Anteromedial triangle,  CN III  Clinoidal ICA clinoid; anterior roof of the cavernous
Anterior triangle  Dural fold between entries of CN II & sinus
III
Supratrochlear Triangle Paramedian triangle,  CN III  MHT Corridor used to locate the origin of
Superior triangle,  CN IV MHT; lateral wall of the cavernous
Fukushima triangle  Dural fold between entries of CN III sinus
& IV
Parkinson’s Triangle Infratrochlear triangle,  CN IV  Cavernous ICA Can be opened to expose CN VI as it
Superolateral triangle,  V1  CN VI crosses the ICA; lateral wall of the
Lateral triangle  Dural fold between CN IV & V1  MHT cavernous sinus

Mullan’s Triangle Anterolateral triangle,  V1  Sphenoid sinus Entry point for exposure of CN VI and
Anteromedial triangle  V2  Ophthalmic v. superior ophthalmic v., access to
 Line from SOF to f. rotundum  CN VI carotid cavernous fistulas

Lateral Triangle Anterolateral,  V2  Lateral sphenoid wing Large pituitary adenomas extending
Far lateral triangle,  V3  Sphenoid emissary v. into the cavernous sinus, corridor
Lateralmost triangle,  Line from f. rotundum to f. ovale  Cavernous-pterygoid venous toward the anterior infratemporal fossa
Lateral loop anastomosis approach
Glasscock’s Triangle Posterolateral triangle  V3  f. spinosum Proximal control of the C6 segment of
 GSPN  Horizontal segment of petrous ICA the ICA
 Line from f. ovale to facial hiatus  Infratemporal fossa
Kawase’s Triangle Posteromedial triangle  Gasserian ganglion  Petrous apex Anterior petrosectomy
 GSPN  IAC
 Line from facial hiatus to petrous  Cochlea
apex
Inferolateral Triangle Trigeminal triangle  Dural entry of CN IV  Porous trigemini Opening of Meckel’s Cave
 Dural entry of CN VI (Dorello’s canal) (Dural opening into Meckel’s cave)
 Petrous apex
Inferomedial Triangle Posteroinferior triangle  Dural entry of CN IV  Porous abducens Opening of Dorello’s canal, exposure
 Dural entry of CN VI (Dorello’s canal) (Dural opening into Dorello’s canal) of CN VI
 Posterior clinoid  Petrosphenoidal (Gruber’s) ligament
Premeatal Triangle  Medial IAC  Cochlea Location of cochlea from the middle
 Geniculate ganglion fossa
 Petrous ICA
Postmeatal Triangle  Lateral IAC  Bone Maximize bone removal of the petrous
 Geniculate ganglion apex
 Arcuate eminence