J Neurol Surg B Skull Base 2014; 75 - A082
DOI: 10.1055/s-0034-1370488

Endoscopic Endonasal Cranial Base Surgery Simulation Using an Artificial Cranial Base Model Created by Selective Laser Sintering

Kenichi Oyama 1, Leo F. S. Ditzel Filho 1, Jun Muto 1, Daniel G. Souza 1, Mateo Zoli 1, Cristian A. Naudy 1, Facundo Van 1, Edward Kerr 1, Ali Jamshidi 1, Bradley A. Otto 1, Ricardo L. Carrau 1, Daniel M. Prevedello 1
  • 1Columbus, USA

Background: Mastery of the expanded endoscopic endonasal approach (EEA) requires anatomical knowledge and surgical skills. While these can be gained by dissection using cadaveric specimens, ethical and legal consideration may interfere with their acquisition.

Objectives: We assessed an artificial cranial base model for the surgical simulation of EEA and compared its usefulness with that of cadaveric specimens.

Methods: The model made of both polyamide nylon and glass beads uses a selective laser sintering (SLS) technique to reflect CT-DICOM data of a patient's head. It features several artificial cranial base structures such as the dura mater, venous sinuses, cavernous sinus, internal carotid artery, and cranial nerves. Under endoscopic view the model was dissected through the nostrils using a high-speed drill and other surgical instruments.

Results: The anatomical structures around and inside the sphenoid sinus were accurately reconstructed in the model and several important surgical landmarks such as the medial- and lateral optico-carotid recess and vidian canals could be observed. The model could be dissected with a high-speed drill and the dura mater was preserved by an eggshell drilling technique very similar to that applied in patients during cranial base manipulation. The model allowed simulation of almost all EEA procedures using both sagittal- and coronal plane modules.

Conclusion: The model created with SLS is a useful tool for acquiring the anatomical knowledge and surgical expertise for performing endoscopic endonasal cranial base surgery while avoiding the ethical-, legal-, and infection-related problems inherent in the use of cadaveric specimens.