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Superior Petrosal Sinus

sinus petrosus superior

The superior petrosal sinus runs along the superior border of the petrous bone in the attached edge of the tentorium cerebelli, draining from the cavernous sinus anteriorly to the transverse sinus posteriorly at the junction where the tentorium attaches to the petrous bone. It drains the superior petrosal vein (which drains the anterolateral pons and lateral cerebellum) and the superior cochlear vein.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The superior petrosal sinus is ligated and divided during the posterior petrosectomy approach to the petroclival region and during retrosigmoid craniotomy extensions that require tentorial incision. Its division allows tentorial incision lateral to the trochlear nerve (CN IV), dramatically widening the corridor to the upper clivus, petrous apex, and basilar artery without retraction. Sampling of the inferior petrosal sinus (not the superior) is the standard for distinguishing pituitary-dependent Cushing disease from ectopic ACTH secretion; the superior petrosal sinus is not used for this purpose.

Pathology

Common Injuries & Conditions

Superior Petrosal Sinus Division in Petrosal Approach

Ligation and division of the superior petrosal sinus allows tentorial incision in the presigmoid retrolabyrinthine and translabyrinthine petrosal approaches to the petroclival region, widening the surgical corridor to the upper basilar artery, petrous apex, and cavernous sinus without cerebellar retraction.