Leonel Luciano César Pc, Carlstrom Lucas P, Graffeo Christopher S, Perry Avital, Pinheiro-Neto Carlos Diogenes, Sorenson Jeffrey, Link Michael J, Peris-Celda Maria
Department of Neurosurgery, Albany Medical Center, Albany, New York, United States.
Northeast Professor Rhoton Dissection Laboratory, Department of Neuroscience and Experimental Therapeutics, Albany, New York, United States.
J Neurol Surg B Skull Base. 2021 Jul;82(Suppl 3):e248-e258. doi: 10.1055/s-0039-3399590. Epub 2019 Nov 28.
This study was aimed to provide a key update to the seminal works of Prof. Albert L. Rhoton Jr., MD, with particular attention to previously unpublished insights from the oral tradition of his fellows, recent technological advances including endoscopy, and high-dynamic range (HDR) photodocumentation, and, local improvements in technique, we have developed to optimize efficient neuroanatomic study. Two formaldehyde-fixed cadaveric heads were injected with colored latex to demonstrate step-by-step specimen preparation for microscopic or endoscopic dissection. One formaldehyde-fixed brain was utilized to demonstrate optimal three-dimensional (3D) photodocumentation techniques. Key steps of specimen preparation include vessel cannulation and securing, serial tap water flushing, specimen drainage, vessel injection with optimized and color-augmented latex material, and storage in 70% ethanol. Optimizations for photodocumentation included the incorporation of dry black drop cloth and covering materials, an imaging-oriented approach to specimen positioning and illumination, and single-camera stereoscopic capture techniques, emphasizing the three-exposure-times-per-eye approach to generating images for HDR postprocessing. Recommended tools, materials, and technical nuances were emphasized throughout. Relative advantages and limitations of major 3D projection systems were comparatively assessed, with sensitivity to audience size and purpose specific recommendations. We describe the first consolidated step-by-step approach to advanced neuroanatomy, including specimen preparation, dissection, and 3D photodocumentation, supplemented by previously unpublished insights from the Rhoton fellowship experience and lessons learned in our laboratories in the past years such that Prof. Rhoton's model can be realized, reproduced, and expanded upon in surgical neuroanatomy laboratories worldwide.
本研究旨在对小阿尔伯特·L·罗顿教授（医学博士）的开创性著作进行重要更新，特别关注其学员口头传承中以前未发表的见解、包括内窥镜检查在内的最新技术进展以及高动态范围（HDR）摄影记录，以及我们为优化高效神经解剖学研究而开发的局部技术改进。 向两个甲醛固定的尸体头部注射彩色乳胶，以展示用于显微镜或内窥镜解剖的逐步标本制备过程。使用一个甲醛固定的大脑来展示最佳的三维（3D）摄影记录技术。 标本制备的关键步骤包括血管插管与固定、连续用自来水冲洗、标本引流、用优化的彩色乳胶材料进行血管注射以及保存在70%乙醇中。摄影记录的优化包括使用黑色干遮光布和覆盖材料、以成像为导向的标本定位和照明方法以及单相机立体捕捉技术，强调每只眼睛采用三次曝光时间的方法来生成用于HDR后处理的图像。通篇强调了推荐的工具、材料和技术细节。对主要3D投影系统的相对优点和局限性进行了比较评估，并针对观众规模和目的给出了具体建议。 我们描述了一种首个综合的高级神经解剖学逐步方法，包括标本制备、解剖和3D摄影记录，并辅以罗顿奖学金经历中以前未发表的见解以及我们实验室过去几年学到的经验教训，以便罗顿教授的模型能够在全球外科神经解剖学实验室中得以实现、复制和扩展。
