title: Intracranial injectable tumor model: technical advancements.
abstract: Background and Objectives Few simulation models are available that provide neurosurgical trainees with the challenge of distorted skull base anatomy despite increasing importance in the acquisition of safe microsurgical and endoscopic techniques. We have previously reported a unique training model for skull base neurosurgery where a polymer is injected into a cadaveric head where it solidifies to mimic a skull base tumor for resection. This model, however, required injection of the polymer under direct surgical vision via a complicated alternative approach to that being studied, prohibiting its uptake in many neurosurgical laboratories. Conclusion We report our updated skull base tumor model that is contrast-enhanced and may be easily and reliably injected under fluoroscopic guidance. We have identified a map of burr holes and injection corridors available to place tumor at various intracranial sites. Additionally, the updated tumor model allows for the creation of mass effect, and we detail the variation of polymer preparation to mimic different tumor properties. These advancements will increase the practicality of the tumor model and ideally influence neurosurgical standards of training.
authors.affiliation: Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
authors.forename: Cristian
authors.initials: C
authors.lastname: Gragnaniello
authors.affiliation: Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Gagliardi
authors.affiliation: Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
authors.forename: Anthony M T
authors.initials: AM
authors.lastname: Chau
authors.affiliation: Department of Neurosurgery, Texas Center for Neurosciences, Beaumont, Texas, United States.
authors.forename: Remi
authors.initials: R
authors.lastname: Nader
authors.affiliation: Department of Neurosurgery, George Washington University, Washington District of Columbia, United States.
authors.forename: Alan
authors.initials: A
authors.lastname: Siu
authors.affiliation: Department of Neurosurgery, George Washington University, Washington District of Columbia, United States.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Litvack
authors.affiliation: Department of Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: Bruno De
authors.initials: BD
authors.lastname: Luca
authors.affiliation: Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia.
authors.forename: Kevin
authors.initials: K
authors.lastname: Seex
authors.affiliation: Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mortini
authors.affiliation: Department of Neurosurgery, George Washington University, Washington District of Columbia, United States.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Caputy
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States.
authors.forename: Ossama
authors.initials: O
authors.lastname: Al-Mefty
keywords: microsurgery; neurosurgical training; skull base; tumor model