Virtual Reality Simulation for the Middle Cranial Fossa Approach: A Validation Study

Area of Science:

• Neurosurgery Simulation
• Surgical Education Technology
• Virtual Reality in Medicine

Background:

• Virtual reality (VR) surgical rehearsal offers a safe educational environment requiring validation.
• The middle cranial fossa (MCF) approach presents a challenging surgical simulation due to limited trainee exposure and high complication risks.

Purpose of the Study:

• To validate a VR simulation of the MCF approach for educational purposes.
• To assess face, content, and construct validities of the MCF VR simulation.
• To evaluate performance changes through serial simulations.

Main Methods:

• A high-fidelity MCF VR simulation was developed using CardinalSim software with cadaveric data.
• Trainees from Neurosurgery and Otolaryngology performed MCF dissections on the VR platform.
• Face and content validities were assessed using Likert scales; construct validity was evaluated by training level, and performance metrics were analyzed.

Main Results:

• The VR simulation achieved face and content validities.
• Trainee performance significantly improved post-simulation, with better dissection times, anterior petrosectomy completeness, and reduced critical structure injuries.
• Construct validity was not demonstrated, as no trainees had prior MCF experience, underscoring the need for simulation.

Conclusions:

• The MCF VR simulation using CardinalSim is validated for face and content.
• The simulation effectively enhances understanding of complex MCF anatomy and neurovascular relationships.
• This VR tool holds potential as a formative educational adjunct for Neurosurgery and Otolaryngology trainees.