title: [The interactive neuroanatomical simulation and practical application of frontotemporal transsylvian exposure in neurosurgery].
abstract: OBJECTIVE
  There is an increased need for new digital education tools in neurosurgical training. Illustrated textbooks offer anatomic and technical reference but do not substitute hands-on experience provided by surgery or cadaver dissection. Due to limited availability of cadaver dissections the need for development of simulation tools has been augmented. We explored simulation technology for producing virtual reality-like reconstructions of simulated surgical approaches on cadaver. Practical application of the simulation tool has been presented through frontotemporal transsylvian exposure.
  
  
  METHODS
  The dissections were performed on two cadaveric heads. Arteries and veins were prepared and injected with colorful silicon rubber. The heads were rigidly fixed in Mayfield headholder. A robotic microscope with two digital cameras in inverted cone method of image acquisition was used to capture images around a pivot point in several phases of dissections. Multilayered, high-resolution images have been built into interactive 4D environment by custom developed software.
  
  
  RESULTS
  We have developed the simulation module of the frontotemporal transsylvian approach. The virtual specimens can be rotated or tilted to any selected angles and examined from different surgical perspectives at any stage of dissections. Important surgical issues such as appropriate head positioning or surgical maneuvers to expose deep situated neuroanatomic structures can be simulated and studied by using the module.
  
  
  CONCLUSIONS
  The simulation module of the frontotemporal transsylvian exposure helps to examine effect of head positioning on the visibility of deep situated neuroanatomic structures and study surgical maneuvers required to achieve optimal exposure of deep situated anatomic structures. The simulation program is a powerful tool to study issues of preoperative planning and well suited for neurosurgical training.
authors.forename: Attila
authors.initials: A
authors.lastname: Balogh
authors.forename: Gábor
authors.initials: G
authors.lastname: Czigléczki
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Papal
authors.forename: Mark C
authors.initials: MC
authors.lastname: Preul
authors.forename: Péter
authors.initials: P
authors.lastname: Banczerowski
mesh_terms: D002102:Cadaver; D002535:Cerebral Aqueduct; D003198:Computer Simulation; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D019635:Neurosurgical Procedures / Q000379:methods*; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000601:surgery*; D014584:User-Computer Interface