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      Operative Anatomy of the Human Skull: A Virtual Reality Expedition

      1 , 2 , 3 , 1 , 4 , 1 , 5
      Operative Neurosurgery
      Oxford University Press (OUP)

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          Abstract

          INTRODUCTION

          The human cranial vault possesses an incredible, complex anatomical intricacy. Bridging the divide between 2-dimensional (2D) learning resources and the 3-dimensional (3D) world in which the anatomy becomes clinically relevant poses an intellectual challenge. Advances in computer graphics and modelling technologies have allowed increasingly accurate and representative resources to supplement cadaveric dissection specimens.

          OBJECTIVE

          To create accurate virtual models of all cranial bones to augment education, research, and clinical endeavours.

          METHODS

          Through a careful analysis of osteological specimens and high-resolution radiographic studies, a highly accurate virtual model of the human skull was created and annotated with relevant anatomical landmarks.

          RESULTS

          The skull was divided into 6 major segments including frontal, ethmoid, sphenoid, temporal, parietal, and occipital bones. These bones were thoroughly annotated to demonstrate the intricate anatomical features.

          CONCLUSION

          This virtual model has the potential to serve as a valuable resource for educational, research, and clinical endeavours, and demonstrates the significance of advances in computer modelling that can contribute to our understanding of neurosurgical anatomical substrates.

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          Most cited references16

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          Simulation of and training for cerebral aneurysm clipping with 3-dimensional models.

          With improvements in endovascular techniques, fewer aneurysms are treated by surgical clipping, and those aneurysms targeted for open surgery are often complex and difficult to treat. We devised a hollow, 3-dimensional (3D) model of individual cerebral aneurysms for preoperative simulation and surgical training. The methods and initial experience with this model system are presented. The 3D hollow aneurysm models of 3 retrospective and 8 prospective cases were made with a prototyping technique according to data from 3D computed tomographic angiograms of each patient. Commercially available titanium clips used in our routine surgery were applied, and the internal lumen was observed with an endoscope to confirm the patency of parent vessels. The actual surgery was performed later. In the 8 prospective cases, the clips were applied during surgery in the same direction and configuration as in the preoperative simulation. Fine adjustments were necessary in each case, and 2 patients needed additional clips to occlude the atherosclerotic aneurysmal wall. With these 3D models, it was easy for neurosurgical trainees to grasp the vascular configuration and the concept of neck occlusion. Practicing surgery with these models also improved their handling of the instruments used during aneurysm surgery, such as clips and appliers. Using the hollow 3D models to simulate clipping preoperatively, we could treat the aneurysms confidently during live surgery. These models allow easy and concrete recognition of the 3D configuration of aneurysms and parent vessels.
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            Using a virtual reality temporal bone simulator to assess otolaryngology trainees.

            The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience. The authors conducted a randomized, blind assessment study. Nineteen volunteers from the Otolaryngology-Head and Neck Surgery training program at the University of Toronto drilled both a cadaveric TB and a simulated VR TB. Expert reviewers were asked to assess operative readiness of the trainee based on a blind video review of their performance. Computerized hand motion analysis of each participant's performance was conducted. Expert raters were able to discriminate novices from experienced trainees (P < .05) on cadaveric temporal bones, and there was a trend toward discrimination on VR TB performance. Hand motion analysis showed that experienced trainees had better movement economy than novices (P < .05) on the VR TB. Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.
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              Virtual temporal bone dissection: an interactive surgical simulator.

              Our goal was to integrate current and emerging technology in virtual systems to provide a temporal bone dissection simulator that allows the user interactivity and realism similar to the cadaver laboratory.
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                Author and article information

                Journal
                Operative Neurosurgery
                Oxford University Press (OUP)
                2332-4252
                2332-4260
                October 2018
                October 01 2018
                September 17 2018
                October 2018
                October 01 2018
                September 17 2018
                : 15
                : 4
                : 368-377
                Affiliations
                [1 ]The Neurosurgical Atlas, Indianapolis, Indiana
                [2 ]Barrow Neurological Institute, Phoenix, Arizona
                [3 ]Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
                [4 ]Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana
                [5 ]Goodman Campbell Brain and Spine and Indiana University School of Medicine, Indianapolis, Indiana
                Article
                10.1093/ons/opy166
                30239872
                1049cccc-2ab3-4569-b908-85f1a0e3eb26
                © 2018

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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