Hydrogen Peroxide Skull Base Specimen Preparation: Singular View of Hidden Topographic Anatomy

To present the technical principles of the hydrogen peroxide head preparation method, and to demonstrate the high quality of anatomical studies performed using these specimens, particularly for arachnoid exploration.

Five cadaveric heads were set with a 10% formalin solution and then injected with coloured latex. Thereafter, the heads were bleached with hydrogen peroxide solution 20%. Anatomical dissection of all specimens was performed. The skull base was drilled, dura mater gradually resected and outer arachnoid membranes examined and opened. The topographical anatomy was studied.

All soft tissues, the brain, cranial nerves, the vasculature, the dura mater and even the arachnoid, were macroscopically intact, which enabled high-quality skull base specimens. In addition, the bone was softened, facilitating the drilling process. The topographical anatomy of anterior clinoid process was selected as an example and depicted in photos.

High-quality anatomical specimens were obtained using the hydrogen peroxide head preparation. The topographic anatomy was studied from a unique downside-up angle, as well as by following the passage of the key neurovascular structures during its course. We propose the use of this method in neurosurgical training, especially to practice extradural approaches. Moreover this method seems promising as a complementary method for arachnoid studies.