Endoscopic skull base training using 3D printed models with pre-existing pathology.

Endoscopic skull base training using 3D printed models with pre-existing pathology.

Narayanan, Vairavan;Narayanan, Prepageran;Rajagopalan, Raman;Karuppiah, Ravindran;Rahman, Zainal Ariff Abdul;Wormald, Peter-John;Van Hasselt, Charles Andrew;Waran, Vicknes;
european archives of oto-rhino-laryngology : official journal of the european federation of oto-rhino-laryngological societies (eufos) : affiliated with the german society for oto-rhino-laryn 2015 Vol. 272 pp. 753-7
261
narayanan2015endoscopiceuropean

Abstract

Endoscopic base of skull surgery has been growing in acceptance in the recent past due to improvements in visualisation and micro instrumentation as well as the surgical maturing of early endoscopic skull base practitioners. Unfortunately, these demanding procedures have a steep learning curve. A physical simulation that is able to reproduce the complex anatomy of the anterior skull base provides very useful means of learning the necessary skills in a safe and effective environment. This paper aims to assess the ease of learning endoscopic skull base exposure and drilling techniques using an anatomically accurate physical model with a pre-existing pathology (i.e., basilar invagination) created from actual patient data. Five models of a patient with platy-basia and basilar invagination were created from the original MRI and CT imaging data of a patient. The models were used as part of a training workshop for ENT surgeons with varying degrees of experience in endoscopic base of skull surgery, from trainees to experienced consultants. The surgeons were given a list of key steps to achieve in exposing and drilling the skull base using the simulation model. They were then asked to list the level of difficulty of learning these steps using the model. The participants found the models suitable for learning registration, navigation and skull base drilling techniques. All participants also found the deep structures to be accurately represented spatially as confirmed by the navigation system. These models allow structured simulation to be conducted in a workshop environment where surgeons and trainees can practice to perform complex procedures in a controlled fashion under the supervision of experts.

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