2026 Poster Presentations
P437: EVALUATING VIRTUAL DISSECTION VERSUS TRADITIONAL LEARNING FOR ENHANCING ANATOMICAL UNDERSTANDING OF THE ENDOSCOPIC ENDONASAL APPROACH
Tatsuya Uchida1; Yuanzhi Xu1; Yuhei Sangatsuda1; Erik Burgos-Sosa1; Vera Vigo1; Masaki Ikegami1; Taichi Kin2; Nobuhito Saito2; Aaron Cohen-Gadol3; Juan Fernandez-Miranda1; 1Department of Neurosurgery, Stanford University; 2Department of Neurosurgery, The University of Tokyo; 3Department of Neurological Surgery, Keck School of Medicine of USC
Background: Virtual dissection (VD) has recently gained attention as an innovative educational tool in skull base surgery, offering learners the ability to actively manipulate and explore anatomy in three dimensions. Traditional resources such as textbooks, lectures, and slide-based materials often fall short in conveying the depth and spatial complexity of critical neurovascular structures encountered during the endoscopic endonasal approach. Although VD has been introduced in various fields, rigorous evidence directly comparing its effectiveness with traditional learning (TL) methods remains limited. Addressing this gap is essential to establish the educational value of VD in neurosurgical training.
Objective: To evaluate the educational effectiveness of a newly developed VD environment for an endoscopic endonasal approach to anatomy by conducting a randomized comparison with TL.
Methods: Twenty-eight neurosurgical residents (postgraduate years 3–7) were randomly assigned to either a VD group (n = 14) or a TL group (n = 14). Both groups followed the same program structure; a pre-test consisting of 20 multiple-choice questions, a 20-min learning session, and a post-test of identical content. The test was designed to evaluate spatial anatomical knowledge and included four sections; bony landmarks of the sphenoid sinus, cavernous sinus anatomy, microvascular anatomy, and neural anatomy, with five questions each and an “I don’t know” option. Gain scores (post – pre) were compared between groups using the Mann–Whitney U test. Analysis of covariance was performed to adjust for pre-test scores and postgraduate year, and intragroup comparisons were conducted using the Wilcoxon signed-rank test.
Results: All participants completed the program. Median postgraduate years were 5.5 (interquartile range 4–6) in the VD group and 4.5 (interquartile range 4–6) in the TL group. The VD group achieved significantly greater overall improvement in total knowledge scores compared with the TL group. In particular, the gain score in “cavernous sinus anatomy” was significantly higher in the VD group (p = 0.005). After adjustment with analysis of covariance, the VD group maintained significantly higher total scores (p = 0.036) and cavernous sinus anatomy scores (p = 0.001). In intragroup analysis both groups improved across several sections, but the magnitude of improvement was consistently greater in the VD group, underscoring its educational impact.
Conclusion: This randomized comparison suggested that VD may provide educational benefits over TL, particularly in facilitating understanding of the complex anatomy of the cavernous sinus. The interactive and immersive features of VD, such as dynamic visualization and procedural simulation, appeared to support enhanced three-dimensional comprehension. While these findings are preliminary due to the limited sample size, they suggest that VD has the potential to serve as a valuable complementary modality that could modernize anatomical education, expand accessibility, and contribute to the training of future neurosurgeons.