Virtual temporal bone: an interactive 3-dimensional learning aid for cranial base surgery.
OBJECTIVE
We have developed an interactive virtual model of the temporal bone for the training and teaching of cranial base surgery.


METHODS
The virtual model was based on the tomographic data of the Visible Human Project. The male Visible Human's computed tomographic data were volumetrically reconstructed as virtual bone tissue, and the individual photographic slices provided the basis for segmentation of the middle and inner ear structures, cranial nerves, vessels, and brainstem. These structures were created by using outlining and tube editing tools, allowing structural modeling either directly on the basis of the photographic data or according to information from textbooks and cadaver dissections. For training and teaching, the virtual model was accessed in the previously described 3-dimensional workspaces of the Dextroscope or Dextrobeam (Volume Interactions Pte, Ltd., Singapore), whose interfaces enable volumetric exploration from any perspective and provide virtual tools for drilling and measuring.


RESULTS
We have simulated several cranial base procedures including approaches via the floor of the middle fossa and the lateral petrous bone. The virtual model suitably illustrated the core facts of anatomic spatial relationships while simulating different stages of bone drilling along a variety of surgical corridors. The system was used for teaching during training courses to plan and discuss operative anatomy and strategies.


CONCLUSIONS
The Virtual Temporal Bone and its surrounding 3-dimensional workspace provide an effective way to study the essential surgical anatomy of this complex region and to teach and train operative strategies, especially when used as an adjunct to cadaver dissections.
Kockro
Ralf A
RA
Department of Neurosurgery, University of Mainz, Mainz, Germany. kockro@yahoo.com
Hwang
Peter Y K
PY
D002343:Carotid Artery, Internal / Q000033:anatomy & histology / Q000601:surgery; D035301:Cranial Fossa, Middle / Q000033:anatomy & histology / Q000601:surgery; D004210:Dissection / Q000295:instrumentation / Q000379:methods; D007758:Ear, Inner / Q000033:anatomy & histology / Q000601:surgery; D004503:Education, Medical, Graduate / Q000379:methods; D005154:Facial Nerve / Q000033:anatomy & histology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D010579:Petrous Bone / Q000033:anatomy & histology / Q000601:surgery; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery*; D012984:Software; D012986:Software Validation; D013663:Teaching / Q000379:methods*; D013701:Temporal Bone / Q000033:anatomy & histology / Q000601:surgery*; D014584:User-Computer Interface; D000159:Vestibulocochlear Nerve / Q000033:anatomy & histology / Q000601:surgery; D053443:Visible Human Projects