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

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.

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.

A Controlled Laboratory and Clinical Evaluation of a Three-dimensional Endoscope for Endonasal Sinus and Skull Base Surgery

2011 ◽  
Vol 25 (3) ◽  
pp. 141-144 ◽  
Author(s):  
Rupali N. Shah ◽  
W. Derek Leight ◽  
Mihir R. Patel ◽  
Joshua B. Surowitz ◽  
Yu-Tung Wong ◽  
...  
Keyword(s):  
Skull Base ◽  
Clinical Evaluation ◽  
Skull Base Surgery ◽  
Three Dimensional

The Role of 3D tractography in Skull Base Surgery: Technological Advances, Feasibility, and Early Clinical Assessment with Anterior Skull Base Meningiomas

2020 ◽  
Author(s):  
Srikant S. Chakravarthi ◽  
Melanie B. Fukui ◽  
Alejandro Monroy-Sosa ◽  
Lior Gonen ◽  
Austin Epping ◽  
...  
Keyword(s):  
Skull Base ◽  
Cranial Nerve ◽  
Skull Base Surgery ◽  
Three Dimensional ◽  
Qualitative Assessment ◽  
Endoscopic Endonasal ◽  
Olfactory Groove ◽  
Volume Functional ◽  
Signal Abnormality ◽  
Anterior Cranial Base

Abstract Objective The aim of this study is to determine feasibility of incorporating three-dimensional (3D) tractography into routine skull base surgery planning and analyze our early clinical experience in a subset of anterior cranial base meningiomas (ACM). Methods Ninety-nine skull base endonasal and transcranial procedures were planned in 94 patients and retrospectively reviewed with a further analysis of the ACM subset. Main Outcome Measures (1) Automated generation of 3D tractography; (2) co-registration 3D tractography with computed tomography (CT), CT angiography (CTA), and magnetic resonance imaging (MRI); and (3) demonstration of real-time manipulation of 3D tractography intraoperatively. ACM subset: (1) pre- and postoperative cranial nerve function, (2) qualitative assessment of white matter tract preservation, and (3) frontal lobe fluid-attenuated inversion recovery (FLAIR) signal abnormality. Results Automated 3D tractography, with MRI, CT, and CTA overlay, was produced in all cases and was available intraoperatively. ACM subset: 8 (44%) procedures were performed via a ventral endoscopic endonasal approach (EEA) corridor and 12 (56%) via a dorsal anteromedial (DAM) transcranial corridor. Four cases (olfactory groove meningiomas) were managed with a combined, staged approach using ventral EEA and dorsal transcranial corridors. Average tumor volume reduction was 90.3 ± 15.0. Average FLAIR signal change was –30.9% ± 58.6. 11/12 (92%) patients (DAM subgroup) demonstrated preservation of, or improvement in, inferior fronto-occipital fasciculus volume. Functional cranial nerve recovery was 89% (all cases). Conclusions It is feasible to incorporate 3D tractography into the skull base surgical armamentarium. The utility of this tool in improving outcomes will require further study.

Three-Dimensional Printing: Current Use in Rhinology and Endoscopic Skull Base Surgery

2019 ◽  
Vol 33 (6) ◽  
pp. 770-781 ◽  
Author(s):  
Christopher M. Low ◽  
Jonathan M. Morris ◽  
Daniel L. Price ◽  
Jane S. Matsumoto ◽  
Janalee K. Stokken ◽  
...  
Keyword(s):  
Patient Education ◽  
3D Printing ◽  
Skull Base ◽  
Surgical Planning ◽  
Skull Base Surgery ◽  
Three Dimensional ◽  
Educational Practice ◽  
3 Dimensional ◽  
Endoscopic Skull Base Surgery ◽  
Surgical Teaching

Background In the discipline of rhinology and endoscopic skull base surgery (ESBS), 3-dimensional (3D) printing has found meaningful application in areas including preoperative surgical planning as well as in surgical education. However, its scope of use may be limited due to the perception among surgeons that there exists a prohibitively high initial investment in resources and time to acquire the requisite technical expertise. Nevertheless, given the ever decreasing cost of advancing technology coupled with the need to understand the complex spatial relationships of the paranasal sinuses and skull base, the use of 3D printing in rhinology and ESBS is poised to blossom. Objective Help the reader identify current or potential future uses of 3D printing technology relevant to their rhinologic clinical or educational practice. Methods A review of published literature relating to 3D printing in rhinology and ESBS was performed. Results Results were reviewed and organized into 5 overarching categories including an overview of the 3D printing process as well as applications of 3D printing including (1) surgical planning, (2) custom prosthetics and implants, (3) patient education, and (4) surgical teaching and assessment. Conclusion In the discipline of rhinology and ESBS, 3D printing finds use in the areas of presurgical planning, patient education, prosthesis creation, and trainee education. As this technology moves forward, these products will be more broadly available to providers in the clinical and educational setting. The possible applications are vast and have great potential to positively impact surgical training, patient satisfaction, and most importantly, patient outcomes.

scholarly journals USE OF THREE-DIMENSIONAL ENDOSCOPY IN ENDONASAL AND ANTERIOR SKULL BASE SURGERY

2021 ◽  
Author(s):  
Amr Kholief ◽  
Ahmed Youseef ◽  
Ahmed Ibrahim ◽  
Samy Elwany ◽  
Shahz Ahmed
Keyword(s):  
Clinical Study ◽  
Skull Base ◽  
Surgical Procedures ◽  
Skull Base Surgery ◽  
Intraoperative Complications ◽  
Three Dimensional ◽  
Anterior Skull Base ◽  
Anatomical Landmarks ◽  
Intraoperative Complication ◽  
3D Endoscope

Objectives: The three dimensional (3D) endoscope is considered as a new surgical tool which used in different approaches in intranasal and anterior skull base surgical procedures. There are many advantages of the 3D endoscopy over the two dimensional (2D) one that have been demonstrated along clinical applications, surgical training and different experimental studies. Our study aimed to show the difference between using the 3D & 2D endoscopes during endonasal and anterior skull base surgery and its importance specially when used by novice users. Design: Our study is divided into two phases (clinical & cadaveric phases).In the clinical study we have done 52 endonasal & anterior skull base surgical procedures (26 study cases and 26 control cases).We recorded accuracy, duration and intraoperative complication for each case. The cadaveric study was performed on three cadavers, difference in accuracy and dissection time were recorded using 3D & 2D endoscopy for each side chosen by randomization. Results: In the clinical study, the cases done by 3D endoscope were significantly faster and more accurate with less intraoperative complications compared to cases done using 2D endoscope. In cadaveric dissection while using 3D endoscope there was better depth of perception regarding the anatomical landmarks compared to 2D endoscope. Conclusion: 3D endoscopy is an advanced instrument that allows better training for the coming generation of ENT surgeons. Both clinical and cadaveric studies offer a promising outcomes in both endonasal and anterior skull base surgery.

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