title: A neurosurgical simulation of skull base tumors using a 3D printed rapid prototyping model containing mesh structures.
abstract: Deep regions are not visible in three-dimensional (3D) printed rapid prototyping (RP) models prepared from opaque materials, which is not the case with translucent images. The objectives of this study were to develop an RP model in which a skull base tumor was simulated using mesh, and to investigate its usefulness for surgical simulations by evaluating the visibility of its deep regions.
  
  
  
  A 3D printer that employs binder jetting and is mainly used to prepare plaster models was used. RP models containing a solid tumor, no tumor, and a mesh tumor were prepared based on computed tomography, magnetic resonance imaging, and angiographic data for four cases of petroclival tumor. Twelve neurosurgeons graded the three types of RP model into the following four categories: 'clearly visible,' 'visible,' 'difficult to see,' and 'invisible,' based on the visibility of the internal carotid artery, basilar artery, and brain stem through a craniotomy performed via the combined transpetrosal approach. In addition, the 3D positional relationships between these structures and the tumor were assessed.
  
  
  
  The internal carotid artery, basilar artery, and brain stem and the positional relationships of these structures with the tumor were significantly more visible in the RP models with mesh tumors than in the RP models with solid or no tumors.
  
  
  
  The deep regions of PR models containing mesh skull base tumors were easy to visualize. This 3D printing-based method might be applicable to various surgical simulations.
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Harada
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masuda
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan. nsugo@med.toho-u.ac.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sugo
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Terazono
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okonogi
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Sakaeyama
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Fuchinoue
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Syunpei
authors.initials: S
authors.lastname: Ando
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fukushima
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nomoto
authors.affiliation: Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, 6-11-1, Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nemoto
mesh_terms: D003198:Computer Simulation; D003399:Craniotomy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D066330:Printing, Three-Dimensional; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Mesh structure; Rapid prototyping model; Skull base tumor; Surgical simulation; Three-dimensional printer