Colored Silicone Injection for Use in Neurosurgical Dissections: Anatomic Technical Note

Sanan, Abhay; Aziz, Khaled; Janjua, Rashid M.; Loveren, Harry R. van; Keller, Jeffrey T.

doi:10.1097/00006123-199911000-00058

Cited by 126 publications

(117 citation statements)

References 7 publications

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“…Cervical arteries and jugular veins in the embalmed groups were cannulated according to previously described methods. 2,17 Arterial and venous systems were cleaned using saline solution until contralateral outflow was clear. This procedure was repeated bilaterally on each cannulated vessel, alternating arterial and venous irrigation.…”

Section: Head Preparationmentioning

confidence: 99%

“…Despite important advances in surgical simulation, 1,2,14,16,17 an embalming formula customized to allow brain retraction while preserving living brain properties is necessary to recreate neurosurgical scenarios in cadavers. In 2002, Aboud et al introduced a revolutionary laboratory model for neurosurgical training that enabled blood hemorrhage simulations in cadaveric specimens.…”

Section: Surgical Simulation Profilesmentioning

confidence: 99%

“…1,4,14,16,17 The main goal of anatomical cadaveric processing is to achieve the most realistic model possible. There have been several major breakthroughs in this field.…”

mentioning

confidence: 99%

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Novel embalming solution for neurosurgical simulation in cadavers

Benet

Rincón-Torroella

Lawton

et al. 2014

JNS

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Object Surgical simulation using postmortem human heads is one of the most valid strategies for neurosurgical research and training. The authors customized an embalming formula that provides an optimal retraction profile and lifelike physical properties while preventing microorganism growth and brain decay for neurosurgical simulations in cadavers. They studied the properties of the customized formula and compared its use with the standard postmortem processing techniques: cryopreservation and formaldehyde-based embalming. Methods Eighteen specimens were prepared for neurosurgical simulation: 6 formaldehyde embalmed, 6 cryopreserved, and 6 custom embalmed. The customized formula is a mixture of ethanol 62.4%, glycerol 17%, phenol 10.2%, formaldehyde 2.3%, and water 8.1%. After a standard pterional craniotomy, retraction profiles and brain stiffness were studied using an intracranial pressure transducer and monitor. Preservation time—that is, time that tissue remained in optimal condition—between specimen groups was also compared through periodical reports during a 48-hour simulation. Results The mean (± standard deviation) retraction pressures were highest in the formaldehyde group and lowest in the cryopreserved group. The customized formula provided a mean retraction pressure almost 3 times lower than formaldehyde (36 ± 3 vs 103 ± 14 mm Hg, p < 0.01) and very similar to cryopreservation (24 ± 6 mm Hg, p < 0.01). For research purposes, preservation time in the cryopreserved group was limited to 4 hours and was unlimited for the customized and formaldehyde groups for the duration of the experiment. Conclusions The customized embalming solution described herein is optimal for allowing retraction and surgical maneuverability while preventing decay. The authors were able to significantly lower the formaldehyde content as compared with that in standard formulas. The custom embalming solution has the benefits from both cryopreservation (for example, biological brain tissue properties) and formaldehyde embalming (for example, preservation time and microorganism growth prevention) and minimizes their drawbacks, that is, rapid decay in the former and stiffness in the latter. The presented embalming formula provides an important advance for neurosurgical simulations in research and teaching.

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Section: Head Preparationmentioning

confidence: 99%

Section: Surgical Simulation Profilesmentioning

confidence: 99%

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Novel embalming solution for neurosurgical simulation in cadavers

Benet

Rincón-Torroella

Lawton

et al. 2014

JNS

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“…13 Nowadays, colored silicone and latex injections have largely replaced other techniques of injecting cadaveric heads. 1,18 Ridley developed innovative and effective methods of tissue dissection. In the preface of his book while describing the methods, he stated, "Some of [the cadavers] have been upon subjects in their natural, some in their morbid, some upon those of untimely death; and on those last sometimes whist the natural fluids remained in their proper vessels, though after a preternatural manner occasioned by strangulation; sometimes when in the room thereof, other bodies have been introduced by injection, as tinged wax and mercury, the first of which by its consistence chiefly, the other by its permanent nature and color, contribute mightily towards bringing to view the most minute ramifications of vessels, and secret recesses of Nature."…”

Section: Selective Cerebrovascular Cadaveric Injectionsmentioning

confidence: 99%

“…Although the use of selective colored cerebrovascular injections in cadaver dissections has recently become a routine practice to enhance the cerebral vasculature, it is an old art that was introduced more than 300 years ago. 1,8,13,14,16,18 Humphrey Ridley, M.D. (1653-1708), a British physician in the 17th century, injected mercury and tinged wax into the cerebral veins of freshly executed criminals, taking advantage of the considerable venous engorgement to demonstrate the anatomy of the venous plexus of the skull base.…”

mentioning

confidence: 99%

Humphrey Ridley (1653–1708): 17th century evolution in neuroanatomy and selective cerebrovascular injections for cadaver dissection

Thakur

Sonig²,

Chittiboina³

et al. 2012

FOC

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Humphrey Ridley, M.D. (1653–1708), is a relatively unknown historical figure, belonging to the postmedieval era of neuroanatomical discovery. He was born in the market town of Mansfield, 14 miles from the county of Nottinghamshire, England. After studying at Merton College, Oxford, he pursued medicine at Leiden University in the Netherlands. In 1688, he was incorporated as an M.D. at Cambridge. Ridley authored the first original treatise in English language on neuroanatomy, The Anatomy of the Brain Containing its Mechanisms and Physiology: Together with Some New Discoveries and Corrections of Ancient and Modern Authors upon that Subject. Ridley described the venous anatomy of the eponymous circular sinus in connection with the parasellar compartment. His methods were novel, unique, and effective. To appreciate the venous anatomy, he preferred to perform his anatomical dissections on recently executed criminals who had been hanged. These cadavers had considerable venous engorgement, which made the skull base venous anatomy clearer. To enhance the appearance of the cerebral vasculature further, he used tinged wax and quicksilver in the injections. He set up experimental models to answer questions definitively, in proving that the arachnoid mater is a separate meningeal layer. The first description of the subarachnoid cisterns, blood-brain barrier, and the fifth cranial nerve ganglion with its branches are also attributed to Ridley. This historical vignette revisits Ridley's life and academic work that influenced neuroscience and neurosurgical understanding in its infancy. It is unfortunate that most of his novel contributions have gone unnoticed and uncited. The authors hope that this article will inform the neurosurgical community of Ridley's contributions to the field of neurosurgery.

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The basilar venous plexus

et al. 2007

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The basilar venous plexus is the anteromedian venous channel of the posterior cranial fossa that has many conflicting and brief descriptions in the extant literature. To our knowledge, no single study has been performed that analyzed this venous structure in detail. The aim of the current study was to elucidate further the anatomy of this structure of the posterior cranial fossa. The authors examined twenty adult cadaveric specimens following injection of the internal jugular veins or cavernous sinus to observe the morphology of the basilar plexus. All specimens were found to have a basilar plexus which was always plexiform and very variable in nature. This structure was dorsal to the clivus superiorly and dorsal clivus and overlying tectorial membrane inferiorly. The mean diameter of the channels making up this plexus was 1.1 mm. Communication was always found between the basilar plexus and the inferior petrosal sinuses and this was the primary route used to drain the basilar sinus out of the cranium. In fact, these two venous structures were more or less contiguous across the midline at multiple levels. In seven specimens (35%), the basilar plexus communicated with veins draining into the hypoglossal canal. The basilar plexus communicated with the marginal sinus in 12 specimens (60%). This plexus became much less concentrated as it descended inferior to a plane between the jugular tubercles. No specimen was found to have connections with veins of the anterior brain stem or ventral surface of the clivus. The basilar plexus is a highly variable posterior fossa venous structure. Clinicians and radiologists should take into account this variability when managing cerebral venous disorders or interpreting imaging studies of the skull base.

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Colored Silicone Injection for Use in Neurosurgical Dissections: Anatomic Technical Note

Abstract: Injection of colored silicone into the vascular tree can enhance the educational value of cadaveric head dissections. This report describes the technique of vascular injection that is used in the Goodyear Microsurgical Laboratory, the University of Cincinnati, and the Mayfield Clinic.

Cited by 126 publications

References 7 publications

Novel embalming solution for neurosurgical simulation in cadavers

Novel embalming solution for neurosurgical simulation in cadavers

Humphrey Ridley (1653–1708): 17th century evolution in neuroanatomy and selective cerebrovascular injections for cadaver dissection

The basilar venous plexus

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