Minimally invasive research of subtemporal approach for exposure of petrous apex utilizing virtual reality skill

doi:10.3969/j.issn.1009-6574.2015.04.010

Abstract：Objective To construct three-dimensional anatomical model of petrous apex virtual reality and discuss the minimally invasive strategy for exposure of petrous apex through subtemporal ap‐proach .Methods Obtaining image data from 15 cases of cadaver heads with head CT and MRI scanning , which was used to establish model in the virtual reality system .Osseous landmark points on the calvaria and skull base were selected to simulate subtemporal approach for exposure of petrous apex .Minimally invasive design was performed by reducing the volume of approach .Changes of anatomy exposures were observed ,measured and compared following minimally invasive design .Results Virtual reality model could clearly show bone and neurovascular structures as subtemporal approach for exposure of petrous a‐pex .Following minimally invasive design ,volumes of surgical route a ,b ,c and osseous structures , temporal lobe ,trigeminal nerve and vein decreased gradually .Volumes of facial -acoustic nerve com‐plex ,greater superficial petrous nerve and labyrinth in road a were more than those in road b .There differences were statistically significant (P< 0 .01) .The differences of above items reached statistical significance .Petrous segment of internal carotid artery only displayed in road a .Conclusions During the minimally invasive design of subtemporal approach exposing petrous apex ,computed virtual reality skill can provide quantitative and objective data .When fixing the approach direction ,narrow path leading to surgical trauma and targets shrunk ,providing guidance for the minimally invasive surgery .