2026 Poster Presentations
P450: PRACTICAL USE OF A THREE DIMENSIONAL ONLINE TRAINING PLATFORM FOR RESIDENTS AND FELLOWS IN TRANSCRANIAL AND ENDONASAL SKULL BASE APPROACHES
Rodrigo Delpino Gehrke, MD1; Guilherme Finger, MD2; Guilherme Mansur, MD3; Moataz D. Abouammo, MD1; Daniel M. Prevedello, MD3; Ricardo L. Carrau, MD, MBA1; 1Department of Otolaryngology/Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA; 2Department of Neurosurgery, Indiana University, Indianapolis, IN, USA; 3Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
Introduction: The skull base is one of the most anatomically complex regions in the human body, containing critical neurovascular structures and offering limited surgical corridors. Mastery of transcranial and endonasal approaches requires a deep understanding of three-dimensional (3D) relationships and precise, stepwise execution—skills that are difficult to acquire through observation alone. Despite their importance, these approaches are often underrepresented in traditional residency and fellowship curricula due to time constraints, limited access to cadaveric labs, and the technical difficulty of reproducing consistent training experiences.
While cadaveric dissection remains the gold standard for hands-on learning, its availability is increasingly restricted by logistical, financial, and institutional barriers. As a result, many trainees graduate without adequate exposure to the operative anatomy and decision-making required for skull base surgery. In this context, digital and interactive tools - particularly those that leverage 3D models and virtual environments - are emerging as essential educational adjuncts. These platforms offer reproducible, on-demand access to complex surgical anatomy and allow for iterative practice that reinforces anatomical knowledge and procedural planning.
Objective: To present early experiences and feedback from neurosurgical and otolaryngology residents and fellows using an online 3D platform of transcranial and endonasal skull base approaches.
Methods: Cadaveric dissections were performed in the ALT-VISION laboratory to illustrate major transcranial and endonasal skull base approaches. These procedures were recorded, reconstructed into 3D models, and integrated into an interactive online platform (https://skullpture.mycarejs.com) with labeling and stepwise visualization. Pilot testing was done by neurosurgery and otolaryngology residents and fellows to obtain their feedback . The study design included pre- and post-use assessments of anatomical knowledge and procedural confidence, with structured feedback collected using the Michigan Standard Simulation Experience Scale (MiSSES) to evaluate usability, realism, and educational value. Data collection and analysis remain in preliminary stages.
Results: Initial feedback from residents and fellows (17) in both specialties has been strongly positive. Users reported improved understanding of skull base anatomy, greater clarity in stepwise surgical techniques, and enhanced confidence in approach planning. The platform’s interactive features - particularly toggleable anatomical labels and sequential surgical flow - were frequently highlighted as valuable for independent study and repeated review. Despite these encouraging results, feedback remains preliminary, and structured evaluation, knowledge assessment results and feedback remain ongoing with expected date to finalize data collection on 10/30/2025.
Conclusion: The use of a three dimensional online training platform as an immersive educational resource has demonstrated promising results among neurosurgical and otolaryngology residents and fellows. Continued testing and formal validation are underway to determine its long-term role as a complement to traditional training and its potential to improve preparedness for complex skull base procedures. Although it does not substitute the laboratory hands on experience, this tool is especially valid for programs that do not have access to cadaveric dissection laboratories or for countries where the costs of maintaining such infrastructure are prohibitive.
