Mori Kentaro, Yamamoto Takuji, Oyama Kazutaka, Nakao Yasuaki
Department of Neurosurgery, Juntendo University, Shizuoka Hospital, 1129 Nagaoka, Izunokuni, Shizuoka, 410-2295, Japan.
Neurosurg Rev. 2009 Apr;32(2):233-8; discussion 238-9. doi: 10.1007/s10143-008-0177-x. Epub 2008 Oct 14.
Experience with dissection of the temporal bone is essential for training in skull-base surgery, but only a limited number of neurosurgical residents have the opportunity of cadaver dissection. A modification of a commercially available prototype three-dimensional (3D) temporal bone model is proposed to include artificial dura mater, venous sinuses, and cranial nerves for such surgical training. The base 3D temporal bone model incorporates the surface details and the inner ear structures and air cells. Model dural sinuses and dura mater made from silicone, cranial nerves made from rubber fibers, and internal carotid artery made from rubber tubes were added to the model. Posterior petrosectomy (transpetrosal approach) and transcondylar approach were performed on this model using a high-speed drill and ultrasonic bone curette under an operating microscope. The modified 3D temporal bone model provided good experience with the complicated 3D anatomy. The model could be dissected, and the dural sinuses and dura mater preserved by the eggshell peeling technique in almost the same way as real temporal bone. The modified 3D temporal bone model provides a good educational tool for training in skull-base surgery.
颞骨解剖经验对于颅底外科手术培训至关重要,但只有少数神经外科住院医师有机会进行尸体解剖。本文提出对市售的三维(3D)颞骨模型进行改良,在模型中加入人工硬脑膜、静脉窦和颅神经,用于此类手术培训。基础3D颞骨模型包含表面细节、内耳结构和气房。在模型中添加了由硅胶制成的硬脑膜窦和硬脑膜、由橡胶纤维制成的颅神经以及由橡胶管制成的颈内动脉。在手术显微镜下,使用高速钻和超声骨刮匙在该模型上进行了后岩骨切除术(经岩骨入路)和经髁入路。改良后的3D颞骨模型提供了对复杂三维解剖结构的良好体验。该模型可以进行解剖,并且可以通过蛋壳剥离技术以与真实颞骨几乎相同的方式保留硬脑膜窦和硬脑膜。改良后的3D颞骨模型为颅底外科手术培训提供了良好的教学工具。