Virtual Anatomic Atlas for Posterior Fossa Approaches and Creating Patient-Specific Surgical 3D Models

The intricate anatomy of the posterior fossa comprises layered muscles, fasciae, and both extracranial and intracranial neurovascular structures. Surgical intervention in this region requires a precise and comprehensive understanding of these structures, which can be difficult to achieve with only 2-dimensional materials. Traditional cadaver dissections provide basic 3-dimensional anatomic insight but are increasingly constrained by cost, ethical concerns, and difficulties in cadaver sourcing. Advances in 3-dimensional (3D) modeling, particularly through photogrammetry, offer an innovative approach for improving visuospatial understanding for neurosurgical education. This study aimed to create realistic 3D models of the suboccipital musculature and neurovascular anatomy of the posterior fossa with photogrammetry. In addition, a middle fossa dissection was included to define cranial nerve pathways, providing a supplementary educational tool for neurosurgical training.

Five silicone-injected cadaveric head specimens were used for posterior and middle fossa dissection under a surgical microscope. Photographs were taken from multiple angles to generate 3D models through photogrammetry, which were then processed with the Scaniverse application and uploaded to the Sketchfab platform. Each model's anatomic structures were labeled and made accessible for augmented reality and virtual reality viewing on multiple devices, enhancing interactive learning experiences. Patient-specific step-by-step 3D models were generated using radiological segmentation to support preoperative planning for the posterior fossa approach.

Sixteen 3D models were created, illustrating detailed anatomy of suboccipital and deep neck muscles, neurovascular structures, and cranial nerve pathways within the posterior and middle fossae. These models improve visualization and spatial understanding of complex anatomic relationships, making them a valuable resource for neurosurgical education.

The 3D models developed in this study provide an effective tool to enhance the spatial understanding of the complex neurovascular anatomy of posterior fossa and cranial nerve routes, supporting and complementing traditional cadaver dissection in neurosurgical training.