{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T20:01:18Z","timestamp":1777320078795,"version":"3.51.4"},"reference-count":17,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nThe main objective of this study is to enhance neurosurgeons\u2019 anatomical knowledge by providing specific anatomical references of the cavernous sinus (CS). However, it is essential to clarify that our study does not seek to establish an absolute intraoperative rule due to the inherent anatomical variability that must be considered.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nFifty-three cadaveric specimens were procured from the Forensic Institute (Bogot\u00e1) and subjected to dissection through an extradural approach. The measurements were taken in two distinct phases. The first phase involved the measurement of various anatomical structures in 25 specimens with respect to the anterior and posterior clinoids. The second phase, which was conducted 5 years later, involved the measurement of the distance between the foramen rotundum and the foramen ovale in 28 specimens using the L&W tools microcaliper.<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nIn 25 specimens, a perpendicular imaginary line was drawn from the lateral tip of the anterior clinoid to the floor of the medial fossa. This facilitated access to the Parkinson\u2019s triangle, which is located between the IV cranial nerve and the ophthalmic V1 nerve, revealing a constant distance of 5 mm between the lateral tip of the anterior clinoid and the IV cranial nerve. Furthermore, in 28 specimens, the mean distance from the foramen rotundum to the foramen ovale was found to be 1.3 cm bilaterally.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThe rule of five is a valuable tool for comprehensively understanding the anatomy of the CS, providing a reference point for the different normal anatomical structures within the CS.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_545_2023","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T07:28:34Z","timestamp":1690529314000},"page":"269","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The rule of five: A novel anatomical landmark for approaching cavernous sinus content"],"prefix":"10.25259","volume":"14","author":[{"given":"Juan Armando","family":"Mejia","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Fundacion Santa Fe de Bogota, Bogota, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximiliano Paez","family":"Nova","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, High Complexity Clinic of the Caribbean, Valledupar, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Garcia","family":"Rairan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad El Bosque, Bogota, Colombia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"10.25259\/SNI_545_2023\/ref-1","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.3171\/2019.6.JNS19262","article-title":"Dr. Dwight Parkinson: A Canadian neurosurgical pioneer","volume":"133","author":"Ajisebutu","year":"2019","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-2","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3171\/2011.12.JNS111251","article-title":"Lateral orbital wall approach to the cavernous sinus: Laboratory investigation","volume":"116","author":"Altay","year":"2012","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-3","doi-asserted-by":"crossref","first-page":"483","DOI":"10.25259\/SNI_764_2022","article-title":"Revisiting Parkinson: After six decades, his triangle remains useful","volume":"13","author":"Alves","year":"2022","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_545_2023\/ref-4","doi-asserted-by":"crossref","first-page":"152004","DOI":"10.1016\/j.aanat.2022.152004","article-title":"Clinical analysis of cavernous sinus anatomy, pathologies, diagnostics, surgical management and complications-Comprehensive review","volume":"245","author":"Balcerzak","year":"2023","journal-title":"Ann Anat"},{"key":"10.25259\/SNI_545_2023\/ref-5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/ajns.AJNS_26_16","article-title":"Review of surgical anatomy of the tumors involving cavernous sinus","volume":"13","author":"Chotai","year":"2018","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-6","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/foc.2001.10.3.11","article-title":"Transmandibular, circumglossal, retropharyngeal approach for chordomas of the clivus and upper cervical spine. Technical note","volume":"10","author":"DeMonte","year":"2001","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_545_2023\/ref-7","doi-asserted-by":"crossref","first-page":"846","DOI":"10.3171\/jns.1989.71.6.0846","article-title":"Surgical alternatives in the treatment of cavernous sinus aneurysms","volume":"71","author":"Diaz","year":"1989","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-8","doi-asserted-by":"crossref","first-page":"E1680","DOI":"10.1002\/hed.24301","article-title":"Endoscopic endonasal study of the cavernous sinus and quadrangular space: Anatomic relationships","volume":"38","author":"Dolci","year":"2016","journal-title":"Head Neck"},{"key":"10.25259\/SNI_545_2023\/ref-9","doi-asserted-by":"crossref","first-page":"101646","DOI":"10.1016\/j.inat.2022.101646","article-title":"Microsurgical technique for en bloc anatomical exenteration of cavernous sinus compartment to treat invasive meningioma","volume":"30","author":"Gonz\u00e1lez-Darder","year":"2022","journal-title":"Interdiscipl Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-10","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1055\/s-0040-1709740","article-title":"Microsurgical and endoscopic anatomy of the cavernous sinus","volume":"39","author":"Isolan","year":"2020","journal-title":"Arq Brasil Neurocir"},{"key":"10.25259\/SNI_545_2023\/ref-11","doi-asserted-by":"crossref","DOI":"10.5603\/FM.a2022.0106","article-title":"Microsurgical anatomy of the cavernous sinus and limitations of surgical approaches: A cadaveric study","volume-title":"Folia Morphol (Warsz)","author":"K\u0131na","year":"2022"},{"key":"10.25259\/SNI_545_2023\/ref-12","doi-asserted-by":"crossref","first-page":"474","DOI":"10.3171\/jns.1965.23.5.0474","article-title":"A surgical approach to the cavernous portion of the carotid artery: Anatomical studies and case report","volume":"23","author":"Parkinson","year":"1965","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_545_2023\/ref-13","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1007\/s00701-016-2940-z","article-title":"Surgical anatomy of the cavernous sinus, superior orbital fissure, and orbital apex via a lateral orbitotomy approach: A cadaveric anatomical study","volume":"158","author":"Ulutas","year":"2016","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_545_2023\/ref-14","doi-asserted-by":"crossref","first-page":"2967","DOI":"10.1007\/s00701-021-04961-6","article-title":"How I do it: Proximal control in Parkinson\u2019s triangle for a very large paraclinoid aneurysm","volume":"163","author":"Volovici","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_545_2023\/ref-15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1002\/ca.10072","article-title":"Anatomical variations of the ten triangles around the cavernous sinus","volume":"16","author":"Watanabe","year":"2003","journal-title":"Clin Anat"},{"key":"10.25259\/SNI_545_2023\/ref-16","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1097\/SCS.0000000000001964","article-title":"Morphological characteristics of the sphenoid sinus and endoscopic localization of the cavernous sinus","volume":"26","author":"Yang","year":"2015","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_545_2023\/ref-17","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4236\/fmar.2015.32012","article-title":"The clinical anatomy of the cavernous sinus","volume":"3","author":"Zhang","year":"2015","journal-title":"Forensic Med Anat Res"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/the-rule-of-five-a-novel-anatomical-landmark-for-approaching-cavernous-sinus-content\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/the-rule-of-five-a-novel-anatomical-landmark-for-approaching-cavernous-sinus-content\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T07:28:56Z","timestamp":1690529336000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/the-rule-of-five-a-novel-anatomical-landmark-for-approaching-cavernous-sinus-content\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,28]]},"references-count":17,"alternative-id":["10.25259\/SNI_545_2023"],"URL":"https:\/\/doi.org\/10.25259\/sni_545_2023","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7,28]]},"article-number":"269"}}