Abstract
Neurosurgical training is being challenged by rigorous work-hour restrictions and the COVID-19 pandemic.1 Now, more than ever, surgical simulation plays a pivotal role in resident education and psychomotor skill development. Three-dimensional (3D) printing technologies enable the construction of inexpensive, patient-specific, anatomically accurate physical models for a more convenient and realistic simulation of complex skull base approaches in a safe environment.2 All stages of the surgical procedure can be simulated, from positioning and exposure to deep microdissection, which has an unparalleled educational value. The complex approach-specific anatomy, narrow working angles, and pathoanatomic relationships can be readily explored from the surgeon's perspective or point of view.2,3 Furthermore, different thermoplastic polymers can be utilized to replicate the visual and tactile feedback of bone (cortical/cancellous), neurological, and vascular tissues.4 Retrosigmoid craniectomies are widely used in neurosurgery with various applications, including microvascular decompressions in patients with trigeminal neuralgia.5-7 Removal of the suprameatal tubercle (SMT) extends the retrosigmoid approach superiorly to the middle fossa and Meckel's cave, and anteriorly to the clivus.8,9 This maneuver may be necessary in patients with prominent SMTs obstructing the view of the trigeminal nerve and in patients with a more anterosuperior neurovascular conflict. This video illustrates a microsurgical training tool for learning and honing the technique of retrosigmoid craniectomy and suprameatal drilling using an affordable (29.00 USD) biomimetic 3D-printed simulator that closely recapitulates not only the anatomy but also the tactile feedback of drilling and manipulating neurological tissues (see Table and Graph 1; minute 07:11) as it happens at the time of surgery.
Keywords: 3D printing, Cerebellopontine angle, Meckel's cave, Skull base, Suprameatal tubercle, Surgical simulation, Trigeminal neuralgia
Funding
This study did not receive any funding or financial support.
Disclosures
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
Contributor Information
Jaime L Martinez, Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina, USA; Neurologic Surgery Department, Mayo Clinic, Jacksonville, Florida, USA.
Aaron Damon, Neurologic Surgery Department, Mayo Clinic, Jacksonville, Florida, USA.
Ricardo A Domingo, Neurologic Surgery Department, Mayo Clinic, Jacksonville, Florida, USA.
Fidel Valero-Moreno, Neurologic Surgery Department, Mayo Clinic, Jacksonville, Florida, USA.
Alfredo Quiñones-Hinojosa, Neurologic Surgery Department, Mayo Clinic, Jacksonville, Florida, USA.
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