Simulation of Extended Endoscopic Endonasal Approaches by Means

of Interactive 3D PDF PresentationLaboratory of Surgical Neuroanatomy

Marija Mavar-Haramija, Alberto Prats-Galino, Juan A. Juanes Méndez, Anna Puigdelívoll-Sánchez, Matteo de Notaris

Skull base surgery

Skull baseo is the most inferior area

of the skull, composed of the endocranium and lower parts of the skull roof.

Skull base surgery

Skull baseTranscranial approaches

Cappabianca et al., Cranial, Craniofacial and Skull Base Surgery, Springer

Skull base surgery

Skull baseTranscranial approachesMinimally invasive procedures:

o endonasal endoscopic surgery

deNotaris et al. World Neurosurgery 2010. AEA, anterior ethmoidal artery; C, clivus; dm, anterior cranial fossa dura mater; ICAs, parasellar tract of the internal carotid artery; O, orbit; OCR, optocarotid recess; ON, optic nerve; SF, sellar floor.

Process

2D Head CT Images 3D Surfaces Reconstruction

Quantitative Analysis

3D PDF

Preoperative Postoperative

EEEA_final.pdf

Quantitative Analysis

Exposure Area

= maximal region exposed during a surgical approach

EEA_final.pdf

Quantitative Analysis

Surgical Freedom= estimate of movement available to a surgeon’s hands and

instruments when manipulating a deep target

SF_final.pdf

and Future Work

3D PDF presentationso Interactive and informative o Free of charge (Adobe Reader) o Easy to use, modify and share

Animations in 3D PDFEndoscopic probe movement simulation

Conclusions

Acknowledgements

Hospital Clínic:o Joaquim Enseñato Isam Alobid

LSNAo Matteo de Notariso Anna Puigdelívoll-Sánchezo Olga Fuenteso Alberto Prats-Galino

USALo Juan A. Juanes Méndez

Motivation

Neurosurical trainingo Dissectionso Virtual models