Construction of a Three-Dimensional Interactive Model of the Skull Base and Cranial Nerves

Neurosurgery ◽  
2007 ◽  
Vol 60 (5) ◽  
pp. 901-910 ◽  
Author(s):  
Yukinari Kakizawa ◽  
Kazuhiro Hongo ◽  
Albert L. Rhoton
Keyword(s):  
Skull Base ◽  
Dura Mater ◽  
Personal Computer ◽  
Focal Point ◽  
Cranial Nerves ◽  
Three Dimensional ◽  
Reference Points ◽  
Operative Planning ◽  
Time Limitations ◽  
D Model

Abstract OBJECTIVE The goal was to develop an interactive three-dimensional (3-D) computerized anatomic model of the skull base for teaching microneurosurgical anatomy and for operative planning. METHODS The 3-D model was constructed using commercially available software (Maya 6.0 Unlimited; Alias Systems Corp., Delaware, MD), a personal computer, four cranial specimens, and six dry bones. Photographs from at least two angles of the superior and lateral views were imported to the 3-D software. Many photographs were needed to produce the model in anatomically complex areas. Careful dissection was needed to expose important structures in the two views. Landmarks, including foramen, bone, and dura mater, were used as reference points. RESULTS The 3-D model of the skull base and related structures was constructed using more than 300,000 remodeled polygons. The model can be viewed from any angle. It can be rotated 360 degrees in any plane using any structure as the focal point of rotation. The model can be reduced or enlarged using the zoom function. Variable transparencies could be assigned to any structures so that the structures at any level can be seen. Anatomic labels can be attached to the structures in the 3-D model for educational purposes. CONCLUSION This computer-generated 3-D model can be observed and studied repeatedly without the time limitations and stresses imposed by surgery. This model may offer the potential to create interactive surgical exercises useful in evaluating multiple surgical routes to specific target areas in the skull base.

scholarly journals Modified Three-Dimensional Skull Base Model With Artificial Dura Mater, Cranial Nerves, and Venous Sinuses for Training in Skull Base Surgery

2008 ◽  
Vol 48 (12) ◽  
pp. 582-588 ◽  
Author(s):  
Kentaro MORI ◽  
Takuji YAMAMOTO ◽  
Kazutaka OYAMA ◽  
Hideaki UENO ◽  
Yasuaki NAKAO ◽  
...  
Keyword(s):  
Skull Base ◽  
Dura Mater ◽  
Skull Base Surgery ◽  
Cranial Nerves ◽  
Three Dimensional ◽  
Venous Sinuses

Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas

2021 ◽  
Author(s):  
Ralf A. Kockro ◽  
Eike Schwandt ◽  
Florian Ringel ◽  
Christian Valentin Eisenring ◽  
Wieslaw Lucjan Nowinski
Keyword(s):  
Skull Base ◽  
Clinical Setting ◽  
Cranial Nerves ◽  
Three Dimensional ◽  
Surgical Anatomy ◽  
University Hospital ◽  
Complex Anatomy ◽  
Operative Strategies ◽  
Interactive 3D ◽  
3D Exploration

Abstract Objective We evaluated the usefulness of a three-dimensional (3D) interactive atlas to illustrate and teach surgical skull base anatomy in a clinical setting. Study Design A highly detailed atlas of the adult human skull base was created from multiple high-resolution magnetic resonance imaging (MRI) and computed tomography (CT) scans of a healthy Caucasian male. It includes the parcellated and labeled bony skull base, intra- and extracranial vasculature, cranial nerves, cerebrum, cerebellum, and brainstem. We are reporting retrospectively on our experiences with employing the atlas for the simulation and teaching of neurosurgical approaches and concepts in a clinical setting. Setting The study was conducted at the University Hospital Mainz, Germany, and Hirslanden Hospital, Zürich, Switzerland. Participants Medical students and neurosurgical residents participated in this study. Results Handling the layered graphical user interface of the atlas requires some training; however, navigating the detailed 3D content from intraoperative perspectives led to quick comprehension of anatomical relationships that are otherwise difficult to perceive. Students and residents appreciated the collaborative learning effect when working with the atlas on large projected screens and markedly improved their anatomical knowledge after interacting with the software. Conclusion The skull base atlas provides an effective way to study essential surgical anatomy and to teach operative strategies in this complex region. Interactive 3D computer graphical environments are highly suitable for conveying complex anatomy and to train and review surgical concepts. They remain underutilized in clinical practice.

The Asterion-to-Transverse Process of the Atlas Line as a Surgical Landmark

2021 ◽  
Author(s):  
Jaafar Basma ◽  
Dom E. Mahoney ◽  
Christos Anagnostopoulos ◽  
L. Madison Michael ◽  
Jeffrey M. Sorenson ◽  
...  
Keyword(s):  
Skull Base ◽  
Cranial Nerves ◽  
Three Dimensional ◽  
Transverse Process ◽  
Jugular Foramen ◽  
Foramen Magnum ◽  
Sigmoid Sinus ◽  
Cervical Region ◽  
Surgical Approaches ◽  
Anatomical Location

Abstract Introduction Proposed landmarks to predict the anatomical location and trajectory of the sigmoid sinus have varying degrees of reliability. Even with neuronavigation technology, landmarks are crucial in planning and performing complex approaches to the posterolateral skull base. By combining two major dependable structures—the asterion (A) and transverse process of the atlas (TPC1)—we investigate the A-TPC1 line in relation to the sigmoid sinus and in partitioning surgical approaches to the region. Methods We dissected six cadaveric heads (12 sides) to expose the posterolateral skull base, including the mastoid and suboccipital bone, TPC1 and suboccipital triangle, distal jugular vein and internal carotid artery, and lower cranial nerves in the distal cervical region. We inspected the A-TPC1 line before and after drilling the mastoid and occipital bones and studied the relationship of the sigmoid sinus trajectory and major muscular elements related to the line. We retrospectively reviewed 31 head and neck computed tomography (CT) angiograms (62 total sides), excluding posterior fossa or cervical pathologies. Bone and vessels were reconstructed using three-dimensional segmentation software. We measured the distance between the A-TPC1 line and sigmoid sinus at different levels: posterior digastric point (DP), and maximal distances above and below the digastric notch. Results A-TPC1 length averaged 65 mm and was posterior to the sigmoid sinus in all cadaver specimens, coming closest at the level of the DP. Using the transverse-asterion line as a rostrocaudal division and skull base as a horizontal plane, we divided the major surgical approaches into four quadrants: distal cervical/extreme lateral and jugular foramen (anteroinferior), presigmoid/petrosal (anterosuperior), retrosigmoid/suboccipital (posterosuperior), and far lateral/foramen magnum regions (posteroinferior). Radiographically, the A-TPC1 line was also posterior to the sigmoid sinus in all sides and came closest to the sinus at the level of DP (mean, 7 mm posterior; range, 0–18.7 mm). The maximal distance above the DP had a mean of 10.1 mm (range, 3.6–19.5 mm) and below the DP 5.2 mm (range, 0–20.7 mm). Conclusion The A-TPC1 line is a helpful landmark reliably found posterior to the sigmoid sinus in cadaveric specimens and radiographic CT scans. It can corroborate the accuracy of neuronavigation, assist in minimizing the risk of sigmoid sinus injury, and is a useful tool in planning surgical approaches to the posterolateral skull base, both preoperatively and intraoperatively.

scholarly journals Three-dimensional Skull Base Model with Retractable Artificial Dura Mater

2009 ◽  
Vol 18 (10) ◽  
pp. 758-764 ◽  
Author(s):  
Kentaro Mori ◽  
Takuji Yamamoto ◽  
Yasuaki Nakao ◽  
Takanori Esaki ◽  
Yumiko Mitome
Keyword(s):  
Skull Base ◽  
Dura Mater ◽  
Three Dimensional

scholarly journals Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations

2005 ◽  
Vol 19 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Luigi M. Cavallo ◽  
Andrea Messina ◽  
Paolo Cappabianca ◽  
Felice Esposito ◽  
Enrico de Divitiis ◽  
...  
Keyword(s):  
Skull Base ◽  
Dura Mater ◽  
Cranial Nerves ◽  
Foramen Magnum ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Lateral Direction ◽  
Endoscopic Endonasal ◽  
Fresh Cadaver ◽  
Csf Leakage

Object The midline skull base is an anatomical area that extends from the anterior limit of the cranial fossa down to the anterior border of the foramen magnum. Resection of lesions involving this area requires a variety of innovative skull base approaches. These include anterior, anterolateral, and posterolateral routes, performed either alone or in combination, and resection via these routes often requires extensive neurovascular manipulation. The goals in this study were to define the application of the endoscopic endonasal approach and to become more familiar with the views and skills associated with the technique by using cadaveric specimens. Methods To assess the feasibility of the endonasal route for the surgical management of lesions in the midline skull base, five fresh cadaver heads injected with colored latex were dissected using a modified endoscopic endonasal approach. Full access to the skull base and the cisternal space around it is possible with this route. From the crista galli to the spinomedullary junction, with incision of the dura mater, a complete visualization of the carotid and vertebrobasilar arterial systems and of all 12 of the cranial nerves is obtainable. Conclusions The major potential advantage of the endoscopic endonasal approach to the skull base is that it provides a direct anatomical route to the lesion without traversing any major neurovascular structures, obviating brain retraction. Many tumors grow in a medial-to-lateral direction, displacing structures laterally as they expand, creating natural corridors for their resection via an anteromedial approach. Potential disadvantages of this procedure include the relatively restricted working space and the danger of an inadequate dural repair with cerebrospinal fluid (CSF) leakage and potential for meningitis resulting. These approaches often require a large opening of the dura mater over the tuberculum sellae and posterior planum sphenoidale, or retroclival space. In addition, they typically involve large intraoperative CSF leaks, which necessitate precise and effective dural closure.

Three-Dimensional Model for Virtual Surgical Simulation, during Complex Skull Base Surgery and Aneurysm Surgery

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Akio Morita ◽  
Toshikazu Kimura ◽  
Shigeo Sora ◽  
Kengo Nishimura ◽  
Hisayuki Sugiyama ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Simulation ◽  
Skull Base Surgery ◽  
Three Dimensional ◽  
Aneurysm Surgery ◽  
Dimensional Model ◽  
Three Dimensional Model

Full tractography for detecting the position of cranial nerves in preoperative planning for skull base surgery: technical note

2020 ◽  
Vol 132 (5) ◽  
pp. 1642-1652 ◽  
Author(s):  
Timothee Jacquesson ◽  
Fang-Chang Yeh ◽  
Sandip Panesar ◽  
Jessica Barrios ◽  
Arnaud Attyé ◽  
...  
Keyword(s):  
Skull Base ◽  
Preoperative Planning ◽  
Skull Base Surgery ◽  
Cranial Nerves ◽  
Patient Specific ◽  
Small Scale ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Brain White Matter ◽  
Human Connectome Project

OBJECTIVEDiffusion imaging tractography has allowed the in vivo description of brain white matter. One of its applications is preoperative planning for brain tumor resection. Due to a limited spatial and angular resolution, it is difficult for fiber tracking to delineate fiber crossing areas and small-scale structures, in particular brainstem tracts and cranial nerves. New methods are being developed but these involve extensive multistep tractography pipelines including the patient-specific design of multiple regions of interest (ROIs). The authors propose a new practical full tractography method that could be implemented in routine presurgical planning for skull base surgery.METHODSA Philips MRI machine provided diffusion-weighted and anatomical sequences for 2 healthy volunteers and 2 skull base tumor patients. Tractography of the full brainstem, the cerebellum, and cranial nerves was performed using the software DSI Studio, generalized-q-sampling reconstruction, orientation distribution function (ODF) of fibers, and a quantitative anisotropy–based generalized deterministic algorithm. No ROI or extensive manual filtering of spurious fibers was used. Tractography rendering was displayed in a tridimensional space with directional color code. This approach was also tested on diffusion data from the Human Connectome Project (HCP) database.RESULTSThe brainstem, the cerebellum, and the cisternal segments of most cranial nerves were depicted in all participants. In cases of skull base tumors, the tridimensional rendering permitted the visualization of the whole anatomical environment and cranial nerve displacement, thus helping the surgical strategy.CONCLUSIONSAs opposed to classical ROI-based methods, this novel full tractography approach could enable routine enhanced surgical planning or brain imaging for skull base tumors.

scholarly journals Filtering Biomechanical Signals in Movement Analysis

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4580
Author(s):  
Francesco Crenna ◽  
Giovanni Battista Rossi ◽  
Marta Berardengo
Keyword(s):  
Measurement Uncertainty ◽  
Dimensional Space ◽  
Three Dimensional ◽  
Movement Analysis ◽  
Analytical Signal ◽  
Human Movement ◽  
Reference Points ◽  
Biomechanical Analysis ◽  
Method Performance ◽  
Acceleration Signal

Biomechanical analysis of human movement is based on dynamic measurements of reference points on the subject’s body and orientation measurements of body segments. Collected data include positions’ measurement, in a three-dimensional space. Signal enhancement by proper filtering is often recommended. Velocity and acceleration signal must be obtained from position/angular measurement records, needing numerical processing effort. In this paper, we propose a comparative filtering method study procedure, based on measurement uncertainty related parameters’ set, based upon simulated and experimental signals. The final aim is to propose guidelines to optimize dynamic biomechanical measurement, considering the measurement uncertainty contribution due to the processing method. Performance of the considered methods are examined and compared with an analytical signal, considering both stationary and transient conditions. Finally, four experimental test cases are evaluated at best filtering conditions for measurement uncertainty contributions.

Sign in / Sign up

Export Citation Format

Share Document