High-Fidelity Simulation for Skull Base Surgery Enabled by Virtual Dura Mater Construction

Area of Science:

• Neurosurgery
• Medical Imaging
• Artificial Intelligence

Background:

• Advanced imaging and AI enable 3D neurosurgical simulations.
• Accurate 3D modeling of the dura mater, especially the tentorium, is challenging.
• Limited fidelity in current simulations hinders preoperative planning for skull base surgery.

Purpose of the Study:

• To present a novel method for virtual dura mater construction in 3D surgical simulation.
• To demonstrate the utility of this technique in planning skull base tumor surgery.

Main Methods:

• Utilized magnetic resonance imaging and contrast-enhanced computed tomography data.
• Extracted and processed regions of interest, including brain parenchyma and cerebrospinal fluid.
• Generated a virtual dura by smoothing, subtraction modeling, and trimming specific anatomical passages, then fused it with existing structures.

Main Results:

• The technique was successfully applied to a petrous apex meningioma case.
• Virtual dura construction allowed detailed comparison of surgical approaches (anterior transpetrosal vs. lateral suboccipital).
• Tumor volume analysis (89.6% infratentorial) supported the lateral suboccipital approach; intraoperative findings confirmed simulation accuracy.

Conclusions:

• This novel technique allows reproducible 3D virtual dura mater construction, enhancing skull base surgery simulation accuracy.
• It serves as a valuable tool for surgical planning, education, and decision-making, particularly for less experienced surgeons.
• The method bridges the gap towards expert-level surgical planning by improving simulation fidelity.