title: Anatomic skull base education using advanced neuroimaging techniques.
abstract: OBJECTIVE
  The goal of the present article was to describe our dissection training system applied to a variety of endoscopic endonasal approaches. It allows one to perform a 3D virtual dissection of the desired approach and to analyze and quantify critical surgical measurements.
  
  
  METHODS
  All the human cadaveric heads were dissected at the Laboratory of Surgical Neuro-Anatomy (LSNA) of the University of Barcelona (Spain). The model surgical training protocol was designed as follows: 1) virtual dissection of the selected approach using our dissection training 3D model; 2) preliminary exploration of each specimen using a second 3D model based on a preoperative computed tomographic scan; 3) cadaveric anatomic dissection with the aid of a neuronavigation system; and 4) quantification and analysis of the collected data.
  
  
  RESULTS
  The virtual dissection of the selected approach, preliminary exploration of each specimen, a real laboratory dissection experience, and finally, the analysis of data retrieved during the dissection step was a complete method for training manual dexterity and hand-eye coordination and to improve the general knowledge of surgical approaches.
  
  
  CONCLUSIONS
  The present model results are found to be effective, providing a valuable representation of the surgical anatomy as well as a 3D visual feedback, thus improving study, design, and execution in a variety of approaches. Such a system can also be developed as a preoperative planning tool that will allow the neurosurgeon to practice and manipulate 3D representations of the critical anatomic landmarks involved in the endoscopic endonasal approaches to the skull base.
authors.affiliation: Department of Neurosurgery, Hospital Clinic, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain. matteodenotaris@gmail.com
authors.forename: Matteo
authors.initials: M
authors.lastname: de Notaris
authors.forename: Thomaz
authors.initials: T
authors.lastname: Topczewski
authors.forename: Michelangelo
authors.initials: M
authors.lastname: de Angelis
authors.forename: Joaquim
authors.initials: J
authors.lastname: Enseñat
authors.forename: Isam
authors.initials: I
authors.lastname: Alobid
authors.forename: Amer Mustafa
authors.initials: AM
authors.lastname: Gondolbleu
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; D003196:Computer Graphics; D003198:Computer Simulation; D004210:Dissection / Q000379:methods; D004724:Endoscopy / Q000379:methods; D006801:Humans; D008953:Models, Anatomic; D009296:Nasal Cavity / Q000601:surgery; D059906:Neuroimaging / Q000379:methods*; D009493:Neurosurgery / Q000193:education; D019635:Neurosurgical Procedures / Q000379:methods; D010902:Pituitary Gland / Q000033:anatomy & histology / Q000601:surgery; D019291:Skull Base / Q000033:anatomy & histology*; D012984:Software; D013100:Sphenoid Bone / Q000033:anatomy & histology / Q000601:surgery; D014584:User-Computer Interface