Intracranial Injectable Tumor Model: Technical Advancements

Cristian Gragnaniello; Filippo Gagliardi; Anthony M.T. Chau; Remi Nader; Alan Siu; Zachary Litvack; Bruno De Luca; Kevin Seex; Pietro Mortini; Anthony J. Caputy; Ossama Al-Mefty

doi:10.1055/s-0034-1368148

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2014; 75(05): 301-308
DOI: 10.1055/s-0034-1368148

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Intracranial Injectable Tumor Model: Technical Advancements

Authors

Cristian Gragnaniello

¹Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
Filippo Gagliardi

²Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
Anthony M.T. Chau

¹Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
Remi Nader

³Department of Neurosurgery, Texas Center for Neurosciences, Beaumont, Texas, United States
Alan Siu

⁴Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
Zachary Litvack

⁴Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
Bruno De Luca

⁵Department of Experimental Medicine, Second University of Naples, Naples, Italy
Kevin Seex

¹Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
Pietro Mortini

²Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
Anthony J. Caputy

⁴Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
Ossama Al-Mefty

⁶Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States

Abstract

Background and Objectives Few simulation models are available that provide neurosurgical trainees with the challenge of distorted skull base anatomy despite increasing importance in the acquisition of safe microsurgical and endoscopic techniques. We have previously reported a unique training model for skull base neurosurgery where a polymer is injected into a cadaveric head where it solidifies to mimic a skull base tumor for resection. This model, however, required injection of the polymer under direct surgical vision via a complicated alternative approach to that being studied, prohibiting its uptake in many neurosurgical laboratories.

Conclusion We report our updated skull base tumor model that is contrast-enhanced and may be easily and reliably injected under fluoroscopic guidance. We have identified a map of burr holes and injection corridors available to place tumor at various intracranial sites. Additionally, the updated tumor model allows for the creation of mass effect, and we detail the variation of polymer preparation to mimic different tumor properties. These advancements will increase the practicality of the tumor model and ideally influence neurosurgical standards of training.

Keywords

neurosurgical training - skull base - tumor model - microsurgery

Full Text

References

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