Abstract
BackgroundThe three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model.MethodsThe 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach were simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test.ResultsThe morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor, whereas the volumetric comparison represented the statistical significant differences of surgical space and bony and neurovascular tissues involved in the two corridors (P<0.001). The differences of bony and neurovascular tissues failed to equal the difference of surgical space.ConclusionsFor far-lateral approach, the increase of exposure for the bony and neurovascular tissues is not necessarily matched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.
Highlights
The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of farlateral approach
The concern of neurovascular protection and skull base reconstruction promotes the development of surgical anatomy for the far-lateral approach [9,10,11]
When bony drilling arrived at the jugular foramen, the surgical space contained posterior portion of glomus jugulare and the lower end of sigmoid sinus
Summary
The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of farlateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Researches had shown that the volumetric measurement was valuable to offer the data for the design of minimally invasive surgery [16, 17]. It is an interesting issue in the surgical design to disclose the interrelation between the surgical space and exposed tissues. We sought to quantify the difference of volumes for the bony and neurovascular structures in the two surgical spaces of far-lateral approach. The relationship in the anatomical exposure generated by the surgical space was demonstrated in detail
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