2026 Poster Presentations
P459: IMPLEMENTING A VIRTUAL REALITY ANATOMICAL MODEL FOR ANTERIOR SKULL BASE SURGICAL EDUCATION
Tony Satroplus, MD1; Steven Goicoechea, MD1; Jer Weann Ang, MS2; Wesley A Fisher2; Eli Piilonen2; Jordan Zhang2; Elizabeth Svoboda, PhD2; Dheeraj Varandani, MS2; Daniel Surdell, MD3; Christie Barnes, MD1; 1University of Nebraska Medical Center, Department of Otolaryngology-Head and Neck Surgery; 2University of Nebraska Medical Center, Interprofessional Experiential Center for Enduring Learning; 3University of Nebraska Medical Center, Department of Neurosurgery
Objective: There is limited application of virtual reality (VR) simulation in skull base anatomical and surgical education. We aim to assess the utility of a high-fidelity interactive three-dimensional (3D) VR model in improving knowledge of anterior skull base anatomy for residents and medical students. The secondary objective was to evaluate the feasibility of integrating VR models into surgical education curricula.
Design: A multidisciplinary group of physicians, computer scientists, and anatomical illustrators contributed to a VR model targeting the surgical anatomy of the anterior skull base. Various patient’s CT scan data of the skull and vasculature was segmented using AMIRA and refined in ZBrush for anatomical accuracy, including skull base foramina. Models were meticulously aligned and retopologized to reduce total polygon count, optimizing them for VR. A prototype of the application was created in ShapesXR and finalized using Unity before being made available on the Meta Quest 3 headset. Study participants included residents in otolaryngology or neurosurgery programs and medical students enrolled in a skull base surgery course. Surveys were developed using an evidence-based 5-point Likert scale for use in clinical simulation research and implemented before and after use of the 3D VR model. Pre- and post-survey responses assessed participants’ perceptions of the VR application. In addition, a web-based interface with the same anatomical model was created for an objective knowledge assessment using 11 standardized anatomical structures. Participants completed pre- and post-VR simulation testing to assess their ability to identify anterior skull base anatomical structures.
Results: Twenty-five participants completed the VR simulation, including 1 medical student and 24 otolaryngology and neurosurgery residents. Twenty-four participants completed the pre-survey (96%) and 20 participants completed the post-simulation survey (80%). Almost half of participants (45.8%) were 30-34 years old (n=11) and over one-third of participants (37.5%) were female (n=9). Nineteen participants had never or infrequently used a VR headset (79.2%). The average pre-simulation quiz score was 7.74 (70% correct score) and average post-simulation quiz score was 9.53 (87% correct score) (p<0.05). Course surveys demonstrated that the VR model improved participants’ level of confidence in identifying anatomical structures, describing the 3D orientation of skull base anatomy, and applying anatomy during surgery (p<0.05). Among participants, 85% agreed or strongly agreed that using the VR model improved their understanding of skull base anatomy (n=17). The most significant barriers to using the VR model were the availability of technology (16%) and time constraints of surgical training (12%).
Conclusion: VR simulation improved residents’ already established knowledge of anterior skull base anatomy. Further work will focus on increasing anatomical fidelity, applicability to medical education and surgery, and availability of technology.
