Anatomic Skull Base Education Using Advanced Neuroimaging Techniques

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• 作者：Matteo de Notaris¹ ; ² ; ^{matteodenotaris@gmail.com} ; Thomaz Topczewski¹ ; Michelangelo de Angelis³ ; Joaquim Enseñ ; at¹ ; Isam Alobid⁴ ; Amer Mustafa Gondolbleu² ; Guadalupe Soria⁵ ; Joan Berenguer Gonzalez⁶ ; Enrique Ferrer¹ ; Alberto Prats-Galino²
• 关键词：3D anatomy ; Endoscopic endonasal approach ; Neuroanatomy ; Pituitary surgery ; Skull base surgery ; Suprasellar area ; Surgical anatomy ; Transsphenoidal surgery
• 刊名：World Neurosurgery
• 出版年：2013
• 出版时间：February, 2013
• 年：2013
• 卷：79
• 期：2_supp_S
• 页码：S16.e9-S16.e13
• 全文大小：2273 K

文摘

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Objective

The goal of the present article was to describe our dissection training system applied to a variety of endoscopic endonasal approaches. It allows one to perform a 3D virtual dissection of the desired approach and to analyze and quantify critical surgical measurements.

Methods

All the human cadaveric heads were dissected at the Laboratory of Surgical Neuro-Anatomy (LSNA) of the University of Barcelona (Spain). The model surgical training protocol was designed as follows: 1) virtual dissection of the selected approach using our dissection training 3D model; 2) preliminary exploration of each specimen using a second 3D model based on a preoperative computed tomographic scan; 3) cadaveric anatomic dissection with the aid of a neuronavigation system; and 4) quantification and analysis of the collected data.

Results

The virtual dissection of the selected approach, preliminary exploration of each specimen, a real laboratory dissection experience, and finally, the analysis of data retrieved during the dissection step was a complete method for training manual dexterity and hand-eye coordination and to improve the general knowledge of surgical approaches.

Conclusions

The present model results are found to be effective, providing a valuable representation of the surgical anatomy as well as a 3D visual feedback, thus improving study, design, and execution in a variety of approaches. Such a system can also be developed as a preoperative planning tool that will allow the neurosurgeon to practice and manipulate 3D representations of the critical anatomic landmarks involved in the endoscopic endonasal approaches to the skull base.