title: The use of a three-dimensional novel computer-based model for analysis of the endonasal endoscopic approach to the midline skull base.
abstract: OBJECTIVE
  To apply a three-dimensional geometric model to various endoscopic endonasal approaches to analyze the bony anatomy of this area, quantify preoperatively bone removal, and optimize surgical planning.
  
  
  METHODS
  Investigators dissected 18 human cadaveric heads at the Laboratory of Surgical NeuroAnatomy (LSNA) of the University of Barcelona (Spain). Before and after each dissection, a computed tomography (CT) scan was performed to create a three-dimensional geometric model of the approach performed in the dissection room. The model protocol was designed as follows: (i) a preliminary exploration of each specimen using the preoperative CT scan, (ii) creation of a computer-generated three-dimensional virtual model of the approach, (iii) cadaveric anatomic dissection, and (iv) development of a CT-based model of the approach as a result of the superimposition of predissection and postdissection digital imaging and communications in medicine (DICOM) images of specimens.
  
  
  RESULTS
  This method employing preliminary virtual exploration of each specimen, the creation of a three-dimensional virtual model of the approach, and the overlapping of the predissection and postdissection three-dimensional models was useful to define the exact boundaries of the endoscopic endonasal craniectomy.
  
  
  CONCLUSIONS
  Aside from laboratory anatomic dissection itself, this model is very effective in providing a depiction of bony landmarks and visual feedback of the amount of bone removed, improving the design of the craniectomy in the endoscopic endonasal midline skull base approach.
authors.affiliation: Department of Neurosurgery, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.forename: Domenico
authors.initials: D
authors.lastname: Solari
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.forename: Joaquim
authors.initials: J
authors.lastname: Enseñat
authors.forename: Isam
authors.initials: I
authors.lastname: Alobid
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Soria
authors.forename: Joan Berenguer
authors.initials: JB
authors.lastname: Gonzalez
authors.forename: Enrique
authors.initials: E
authors.lastname: Ferrer
authors.forename: Alberto
authors.initials: A
authors.lastname: Prats-Galino
mesh_terms: D002102:Cadaver; D003198:Computer Simulation / Q000592:standards*; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D009296:Nasal Cavity / Q000000981:diagnostic imaging* / Q000601:surgery*; D019291:Skull Base / Q000000981:diagnostic imaging* / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods