Preliminary experience with a new three-dimensional computer-based model for the study and the analysis of skull base approaches.
OBJECTIVE
The goal of the present study was to develop a three-dimensional (3D) geometrical model based on pre- and post-dissection Digital Imaging and Communication in Medicine (DICOM) images of both transcranial and endonasal skull base approaches. Such model was structured for either teaching surgical anatomy and to evaluate the amount of bone removal over the skull base surface through a 3D digital perspective.


METHODS
Twenty-five human cadaveric heads were dissected at the Laboratory of Surgical NeuroAnatomy (LSNA) of the University of Barcelona (Spain) between 2007 and 2009. Before and after each dissection, a computed tomography-scan (CT-scan) was obtained in order to create a 3D geometrical model of the same approach performed in the dissection laboratory. The model protocol was designed as follows: (1) preoperative CT-scan of the specimens; (2) creation of a computer-generated 3D model of the specimen using specific imaging software for visualization and manipulation of biomedical data; (3) dissection of the specimens; (4) development of a 3D CT-based model of the approach as a result of the overlapping of the DICOM data of the specimens before and after the dissection.


RESULTS
The fusion of the pre- and post-dissection 3D models allowed evaluation of the amount of bone removal over the skull base surface.


CONCLUSIONS
Measurements of the bony landmarks as well as the visual feedback of the drilled bone over the skull base provided by our 3D model gives the opportunity to improve the tailoring of each approach to the different skull base areas.
de Notaris
Matteo
M
Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy. matteodenotaris@gmail.com
Prats-Galino
Alberto
A
Cavallo
Luigi Maria
LM
Esposito
Felice
F
Iaconetta
Giorgio
G
Gonzalez
Joan Berenguer
JB
Montagnani
Stefania
S
Ferrer
Enrique
E
Cappabianca
Paolo
P
D002102:Cadaver; D003198:Computer Simulation; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008953:Models, Anatomic; D009493:Neurosurgery / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods; D019291:Skull Base / Q000033:anatomy & histology*; D025321:Surgery, Computer-Assisted / Q000379:methods*