Dissectable Modified Three-Dimensional Temporal Bone and Whole Skull Base Models for Training in Skull Base Approaches

ABSTRACT

Training in dissection of the skull base is essential for anatomical understanding and correct surgical techniques, but chances for cadaver dissection are limited, so a substitute is very desirable. Modifications of commercially available three-dimensional (3D) temporal bone and whole skull base models made from surgically dissectable artificial bone are proposed to include artificial dura mater, venous sinuses, carotid artery, and cranial nerves as educational tools for training in skull base surgery. These 3D models precisely reproduce the surface details and inner bony structures such as the cranial foramina, inner ear organs, air cells, and so on. Dura mater and venous sinuses are made from silicone, cranial nerves from rubber fibers, and the internal carotid artery from vinyl tube. Simulations of skull base techniques were performed on these models using a high-speed drill under the operating microscope. The dissected models were evaluated by bone density computed tomography scans to confirm the areas of bony removal. The three steps of reconstruction of the skull base model, dissection, and observation of the dissected model promote clear understanding of the 3D anatomy and acquisition of surgical techniques in the skull base.

Skull base surgery - temporal bone - cavernous sinus - surgical anatomy - training model

REFERENCES

• 1 Suzuki M, Ogawa Y, Hagiwara A, Yamaguchi H, Ono H. Rapidly prototyped temporal bone model for otological education.  ORL J Otorhinolaryngol Relat Spec. 2004;  66(2) 62-64
• 2 Mori K. Three-dimensional temporal bone model for training in skull-base surgery [in Japanese].  Jpn J Neurosurg (Tokyo). 2008;  17 615-621
• 3 Mori K, Yamamoto T, Oyama K, Nakao Y. Three-dimensional cavernous sinus model for understanding cavernous sinus-related surgical anatomy [in Japanese].  Jpn J Neurosurg. , (Tokyo) 2008;  17 940-945
• 4 McAlea K, Forderhase P, Hejimadi U, Nelson C. Material and applications for the SLS selective laser sintering process. In: Chartoff R Proceedings of the 7th International Conference on Rapid Prototyping. Dayton, OH; University of Dayton 1997: 23-33
• 5 Kawase T, van Loveren H, Keller J T, Tew J M. Meningeal architecture of the cavernous sinus: clinical and surgical implications.  Neurosurgery. 1996;  39(3) 527-534 discussion 534-536
• 6 Hakuba A, Nishimura S, Inoue Y. Transpetrosal-transtentorial approach and its application in the therapy of retrochiasmatic craniopharyngiomas.  Surg Neurol. 1985;  24(4) 405-415
• 7 Miller C G, van Loveren H R, Keller J T, Pensak M, el-Kalliny M, Tew Jr J M. Transpetrosal approach: surgical anatomy and technique.  Neurosurgery. 1993;  33(3) 461-469 discussion 469
• 8 Kawase T, Shiobara R, Toya S. Anterior transpetrosal-transtentorial approach for sphenopetroclival meningiomas: surgical method and results in 10 patients.  Neurosurgery. 1991;  28(6) 869-875 discussion 875-876
• 9 Dolenc V V. A combined epi- and subdural direct approach to carotid-ophthalmic artery aneurysms.  J Neurosurg. 1985;  62(5) 667-672