Anatomic Skull Base Education Using Advanced Neuroimaging Techniques

作者：de Notaris Matteo^*; Topczewski Thomaz; de Angelis Michelangelo; Ensenat Joaquim; Alobid Isam; Mustafa Gondolbleu Amer; Soria Guadalupe; Berenguer Gonzalez Joan; Ferrer Enrique; Prats Galino Alberto

来源：World Neurosurgery, 2013, 79(2): UNSP S16.e9.

DOI：10.1016/j.wneu.2012.02.027

• 3D anatomy
• Endoscopic endonasal approach
• Neuroanatomy
• Pituitary surgery
• Skull base surgery
• Suprasellar area
• Surgical anatomy
• Transsphenoidal surgery

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. %26lt;br%26gt;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. %26lt;br%26gt;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. %26lt;br%26gt;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.

• 出版日期2013-2