Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas

Abstract

Objective We evaluated the usefulness of a three-dimensional (3D) interactive atlas to illustrate and teach surgical skull base anatomy in a clinical setting. Study Design A highly detailed atlas of the adult human skull base was created from multiple high-resolution magnetic resonance imaging (MRI) and computed tomography (CT) scans of a healthy Caucasian male. It includes the parcellated and labeled bony skull base, intra- and extracranial vasculature, cranial nerves, cerebrum, cerebellum, and brainstem. We are reporting retrospectively on our experiences with employing the atlas for the simulation and teaching of neurosurgical approaches and concepts in a clinical setting. Setting The study was conducted at the University Hospital Mainz, Germany, and Hirslanden Hospital, Zürich, Switzerland. Participants Medical students and neurosurgical residents participated in this study. Results Handling the layered graphical user interface of the atlas requires some training; however, navigating the detailed 3D content from intraoperative perspectives led to quick comprehension of anatomical relationships that are otherwise difficult to perceive. Students and residents appreciated the collaborative learning effect when working with the atlas on large projected screens and markedly improved their anatomical knowledge after interacting with the software. Conclusion The skull base atlas provides an effective way to study essential surgical anatomy and to teach operative strategies in this complex region. Interactive 3D computer graphical environments are highly suitable for conveying complex anatomy and to train and review surgical concepts. They remain underutilized in clinical practice.

Towards an Architecture of a Multi-purpose, User-Extendable Reference Human Brain Atlas

“…We also have focused on neuroeducation applications, attempting to go beyond a typical atlas use in brain atlas products, such as VOXEL-MAN (Hoehne, 2001) or Interactive Head & Neck (Berkovitz et al, 2003). Our novel educational employment of the brain atlas is for self-testing and classroom assessment (Nowinski et al, 2009c) available on computers and mobile devices, interdisciplinary education across neuroanatomy-neuroradiology-neurology (Nowinski & Chua, 2013), generation of teaching materials (Nowinski et al, 2011(Nowinski et al, , 2015, advanced education for residents and clinicians (Nowinski et al, 2014b(Nowinski et al, , 2015Kockro et al, 2021), and patients' education and instruction (Nowinski, 2016).…”

Anatomic Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Infratemporal Fossa Approach to the Jugular Foramen

“…The ITF approach and variations can be challenging due to complex anatomy and unfamiliarity by many surgeons. Although described before by Fisch and others, 1,2,5-7 these descriptions focus on the complex anatomy of the space and are not optimized for surgical education. Furthermore, with the increasing adoption of stereotactic radiosurgery for the treatment of jugular foramen tumors, familiarity with this operation is waning.…”