2025 Proffered Presentations
S142: DEVELOPMENT OF A COMPREHENSIVE PHOTOGRAMMETRIC ATLAS OF ENDOSCOPIC ENDONASAL APPROACHES
Amedeo Piazza, MD, PhDs1; Yohan Alexander, BA1; Fabio Torregrossa, MD1; Luciano L Leonel, PhD1; Carlos D Pinheiro-Neto, MD, PhD1; Antonio Santoro2; Matteo De Notaris, MD, PhD3; Maria Peris Celda, MD, PhD1; 1Mayo Clinic; 2Sapienza University of Rome; 3University of Salerno, Italy
Introduction: Endoscopic endonasal approaches are a crucial part of the armamentarium of the modern skull base surgeon as they afford direct access to deep-seated structures and with excellent visualization and maneuverability. Nonetheless, there is a steep learning curve for these approaches, and a comprehensive understanding of the bony drilling and dissection required to perform various EEAs and what they expose has traditionally required hours of dedicated practice in cadaveric labs. Thus we aim to create an endoscopic photogrammetry atlas (EPA) aimed at mitigating these obstacles by offering high-quality three-dimensional renderings of anatomical structures encountered during endoscopic dissections.
Methods: Four latex-injected cadaveric specimens were dissected. The endoscopic endonasal transsellar, transplanum, transcavernous, transclival, and transpterygoid approaches were performed. Utilizing a rigid endoscope, a total of 600 pictures were meticulously captured at each critical step. Subsequently, these pictures were processed through Agisoft-Metashape to generate interactive three-dimensional models. Further refinement was achieved using Blender software and lots and lots and lots of photoshop. These models were then uploaded onto a virtual reality for interactive use.
Results: 15 high-resolution (8K) models were generated, based on a database of 9,000 endoscopic pictures. These models, once overlaid and integrated into virtual reality, afforded users the ability to navigate and modularly remove bone that correlates to the EEAs of interest.
Conclusions: In this study we created the EPA which affords users the ability to virtually dissect and remove bone from the skull base.
