Introduction: Skull base anatomy through a transphenoidal approach is challenging for the neurosurgical resident to conquer. Typically, the anatomy is learned through 2-D books and presentations. Stereolithography, or 3D printing, allows residents to examine this complex anatomy in a three-dimensional view.
Methods: Prior to any formal teaching, residents were brought into the operating room where they were asked to identify key structures seen through an endoscopic transphenoidal approach. Scoring was based on correctly naming the anatomical structures. After the initial testing, all residents participated in a didactic lecture reviewing skull base anatomy through a transphenoidal approach using powerpoint with 2D pictures. Residents were then divided into two groups: A & B. Group B residents were additionally taught transphenoidal anatomy through neurosurgical simulation using a 3D-printed model and an endoscope. Following all formal teaching, residents were once again brought back to the operating room where the initial testing was repeated.
Results: A maximum score of 8 points was possible if all the structures were identified correctly. Group A had mean scores of 2.75 on initial testing compared to 5 after lecture (p=0.041 using two-tailed t-test). Group B had mean scores of 2.75 on initial testing compared to 7.5 after lecture and 3D model simulation (p=0.002). When comparing mean scores after formal teaching in groups A & B, 5 vs. 7.5 for lecture only vs. lecture and 3D model simulation, respectively (p=0.031).
Conclusions: 3D models used in neurosurgical simulation to teach skull base anatomy through a transphenoidal approach showed statistically significant improvement in testing scores in neurosurgery residents. Residents also felt a subjective improvement. This study confirms that 3D models are a useful educational tool.
Patient Care: The use of 3D models in neurosurgical simulation will help neurosurgery residents better understand skull base anatomy through a transphenoidal approach, which will allow them to make operations of the sellar and parasellar region safer.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) describe how 3D-printed models are created, 2) understand how 3D models are used in simulation, and 3) discuss how skull base anatomy can be taught using 3D models