A Novel and Cost-Effective Technique for Quantitative Measurement of Endoscopic Photogrammetric Model

In skull base surgery, endoscopic endonasal approaches require precise evaluation of the area of exposure and the maneuverability provided by each approach. Current neuroanatomical methodologies for quantifying these parameters primarily rely on computed tomography (CT) scans and neuronavigation systems, which entail significant financial investment. The aim of this study was to develop and validate an innovative, cost-effective methodology using an endoscopic photogrammetric model to measure the exposure area and maneuverability in endoscopic endonasal approaches, offering an accessible alternative to existing techniques.

Six cadaveric specimens were used to validate the accuracy of endoscopic photogrammetric measurements by comparing them with direct measurements. Subsequently, the exposure area, angle of attack, and surgical freedom were analyzed for 3 endoscopic approaches to the parasellar region: contralateral transmaxillary, single-nostril, and double-nostril approaches.

Photogrammetric measurements demonstrated a high level of concordance with direct cadaveric measurements, with a mean difference of 0.02 mm as shown in the Bland-Altman plot.In addition, measurements obtained in comparative analysis describing the exposure area and maneuverability of 3 endoscopic approaches were congruent with those reported in existing literature derived using CT scans and neuronavigation systems.

To our knowledge, this study is the first to validate endoscopic photogrammetric models as a measurement tool in neuroanatomy. Performing direct measurements on 3D models might eliminate the necessity of expensive CT and neuronavigation systems for volumetric quantification. Our cost-effective methodology allows for the widespread democratization of anatomical quantification within skull base neuroanatomy.