Virtual Exploration of Safe Entry Zones in the Brainstem: Comprehensive Definition and Analysis of the Operative Approach

Abstract

Background Detailed and accurate understanding of intrinsic brainstem anatomy and the inter-relationship between its internal tracts and nuclei and external landmarks is of paramount importance for safe and effective brainstem surgery. Using anatomical models can be an important step in sharpening such understanding. Objective To show the applicability of our developed virtual 3D model in depicting the safe entry zones (SEZs) to the brainstem. Methods Accurate 3D virtual models of brainstem elements were created using high-resolution magnetic resonance imaging and computed tomography to depict brainstem SEZs. Results All the described SEZs to different aspects of the brainstem were successfully depicted using our 3D virtual models. Conclusions The virtual models provide an immersive experience of brainstem anatomy, allowing users to understand the intricacies of the microdissection that is necessary to appropriately traverse the brainstem nuclei and tracts toward a particular target. The models provide an unparalleled learning environment for illustrating SEZs into the brainstem that can be used for training and research.