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

Cristian Gragnaniello
1   Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
,
Filippo Gagliardi
2   Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
,
Anthony M.T. Chau
1   Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
,
Remi Nader
3   Department of Neurosurgery, Texas Center for Neurosciences, Beaumont, Texas, United States
,
Alan Siu
4   Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
,
Zachary Litvack
4   Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
,
Bruno De Luca
5   Department of Experimental Medicine, Second University of Naples, Naples, Italy
,
Kevin Seex
1   Macquarie Neurosurgery, Australian School of Advanced Medicine, Macquarie University, Sydney, Australia
,
Pietro Mortini
2   Department of Neurosurgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
,
Anthony J. Caputy
4   Department of Neurosurgery, George Washington University, Washington District of Columbia, United States
,
Ossama Al-Mefty
6   Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

05 October 2013

22 November 2013

Publication Date:
21 July 2014 (online)

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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.