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Endoscopic endonasal cranial base surgery simulation using an artificial cranial base model created by selective

Kenichi Oyama1, Leo F S Ditzel Filho, Jun Muto

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Summary

A novel artificial cranial base model, created using selective laser sintering, effectively simulates the expanded endoscopic endonasal approach (EEA). This 3D printed model offers a valuable, ethical alternative to cadaveric dissection for surgical training in EEA.

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Area of Science:

  • Neurosurgery
  • Medical Simulation
  • Anatomical Modeling

Background:

  • Mastery of the expanded endoscopic endonasal approach (EEA) demands significant anatomical knowledge and surgical proficiency.
  • Cadaveric dissection is a traditional method for EEA training but faces ethical, religious, and legal limitations globally.
  • There is a need for alternative, accessible methods to train surgeons in complex cranial base procedures.

Purpose of the Study:

  • To evaluate the utility of an artificial cranial base model for surgical simulation of the expanded endoscopic endonasal approach (EEA).
  • To compare the effectiveness of this artificial model with traditional cadaveric specimens for EEA training.

Main Methods:

  • An artificial cranial base model was fabricated using selective laser sintering (SLS) technology, incorporating polyamide nylon and glass beads based on CT-DICOM data.
  • The model accurately replicated key anatomical structures, including the dura mater, venous sinuses, internal carotid arteries, and cranial nerves.
  • Simulated EEA dissections were performed endonasally using standard surgical instruments and an endoscope, mirroring techniques used in patient surgery.

Main Results:

  • The SLS-based artificial model successfully reconstructed anatomical details around and within the sphenoid sinus, including critical surgical landmarks like optico-carotid recesses and vidian canals.
  • Surgical simulation on the model allowed for bone removal to an eggshell-thin consistency while preserving the dura mater, mimicking in-vivo EEA techniques.
  • The model facilitated the simulation of nearly all sagittal and coronal plane EEA modules, demonstrating its comprehensive training potential.

Conclusions:

  • Selective laser sintering (SLS) modeling provides a valuable tool for acquiring anatomical knowledge and surgical skills for the expanded endoscopic endonasal approach (EEA).
  • This artificial model serves as an effective, ethical, and infection-free alternative to cadaveric specimens for EEA surgical simulation and training.
  • The use of 3D printed anatomical models can overcome limitations associated with cadaveric dissection, enhancing surgical education globally.