Skull Base 2010; 20(4): 229-236
DOI: 10.1055/s-0030-1247632
ORIGINAL ARTICLE

© Thieme Medical Publishers

Surgical Simulation of Extradural Anterior Clinoidectomy through the Trans-superior Orbital Fissure Approach Using a Dissectable Three-dimensional Skull Base Model with Artificial Cavernous Sinus

Kentaro Mori1 , Takuji Yamamoto1 , Yasuaki Nakao1 , Takanori Esaki1
  • 1Department of Neurosurgery, Juntendo University, Shizuoka Hospital, Shizuoka, Japan
Further Information

Publication History

Publication Date:
29 January 2010 (online)

ABSTRACT

Extradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model made from surgically dissectable artificial bone with artificial cavernous sinus including multiple membranous layers and neurovascular structures to simulate extradural anterior clinoidectomy via the trans-SOF approach. The 3-D skull base model precisely reproduced the dura propria of the temporal lobe, periosteal bridge, and inner reticular layer in the cavernous sinus and SOF using silicone and varnish. The cranial nerves and blood vessels were made from rubber fibers and vinyl tube. Simulation of extradural anterior clinoidectomy via the trans-SOF approach could be performed on the model using a high-speed drill under the operating microscope. The steps of reconstruction of the skull base model and dissection promote clear understanding of the 3-D anatomy and techniques of extradural anterior clinoidectomy via the trans-SOF approach.

REFERENCES

Kentaro Mori, M.D. , Ph.D. 

Professor, Department of Neurosurgery, Juntendo University, Shizuoka Hospital

1129 Nagaoka, Izunokuni, Shizuoka 410-2295, Japan

Email: kmori@med-juntendo.jp