Application of virtual reality technology in minimally invasive route of exposing middle segment of the clivus via retrosigmoidal approach
Zhou Qing
Tang Ke
Xie Jinjuan
Abstract：Objective To explore the practicability of minimally invasive design exposing middle segment of the clivus via retrosigmoidal approach based on virtual reality anatomic model. Methods CT and MRI scans were performed for 15 adult cadaver heads, and the image was inputted into virtual reality system to establish three-dimensional anatomical model of skull base. Surgical route of retrosigmoidal approach exposing middle segment of the clivus was simulated by outlining cylinder based on osseous landmark points on the calvaria and skull base. The diameter of cylinder was rescaled to make minimally invasive design. Anatomic difference of pre-design versus post-design was observed, measured and compared. Results Retrosigmoidal approach passed the inferior to the transverse sinus and the posterior to the sigmoid sinus. When arriving at the middle segment of the clivus, the volumes of osseous structures, artery, cerebellum, brainstem, and cranial nerve involved in the route were larger before minimally invasive design than following the design. All above differences reached statistical significance (P<0.01). The route following design avoided the inferior petrosal sinus and osseous structures in the skull base. Conclusions Virtual reality technology can be used to make quantitative comparison of micro-anatomic features for minimally invasive design. The route following minimally invasive design in exposing the middle segment of the clivus via retrosigmoidal approach is helpful for reducing stretch injury of neurovascular structures.
Keywords：surgical approachretrosigmoidalclivustechniquevirtual realityneuroanatomy
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 131-133 )