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Piazza A, Spiriev T, Corvino S, Corrivetti F, Laleva L, Iaconetta G, de Notaris M. The Course of the Trochlear Nerve Presented via a 3-Dimensional Photorealistic Anatomic Model. World Neurosurg 2024; 186:e156-e160. [PMID: 38548050 DOI: 10.1016/j.wneu.2024.03.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/16/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Several factors contribute to the anatomical complexity of the trochlear nerve, including small diameter, complex and longest intracranial course, deep location, and numerous neurovascular relationships. A 3-dimensional (3D) photorealistic model of the cranial nerves provides a detailed and immersive representation of the anatomy, enabling one to improve surgical planning, advanced surgical research, and training. The purpose of this work is to present a 3D photogrammetric study for a more intuitive and interactive way to explore and describe the entire course of trochlear nerve. METHODS Two injected-fixed head human specimens (4 sides) were examined. The dissection protocol was divided into the following steps: 1) brain hemisphere exposure; 2) hemispherectomy dissecting all cranial nerves and partial removal of the free edge of the tentorium; 3) middle fossa and lateral wall of cavernous sinus exposure; and 4) orbital exposure. A detailed 3D photogrammetric model was generated for each dissection step. RESULTS Four main volumetric models were generated during a step-by-step layered dissection of the entire nerve pathway highlighting its different segments. Finally, a full and integrated model of the entire course of the nerve was created. The models are available for visualization on monoscopic display, virtual, and augmented reality environment. CONCLUSIONS The present photogrammetric model provides a more comprehensive understanding of the nerve's anatomy in its different segments, allows for customizable views thus simulating different perspectives, and can be a valuable alternative to traditional dissections. It is an advanced tool for surgical planning and surgical simulation as well as virtual reality representation of the anatomy.
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Affiliation(s)
- Amedeo Piazza
- Department of Neurosurgery, Sapienza University, Rome, Italy; Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy
| | - Toma Spiriev
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Sergio Corvino
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy
| | - Francesco Corrivetti
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy.
| | - Lili Laleva
- Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria
| | - Giorgio Iaconetta
- Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy
| | - Matteo de Notaris
- Laboratory of Neuroanatomy, EBRIS Foundation, Salerno, Italy; Department of Neurosurgery, Acibadem Cityclinic University Hospital Tokuda, Sofia, Bulgaria; Department of Neurosciences, Reproductive and Odontostomatological Sciences, Neurosurgical Clinic, School of Medicine, University of Naples "Federico II", Naples, Italy; Department of Neurosurgery, San Luca Hospital, Vallo della Lucania, Salerno, Italy; Unit of Neurosurgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy; Neuroanatomy Committee of the Italian Society of Neurosurgery, SINch, Italy
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Bocanegra-Becerra JE, Canaz G, Vatcheva C, Wellington J. Internal Carotid Artery Classification Systems: An Illustrative Review. World Neurosurg 2022; 163:41-49. [PMID: 35367392 DOI: 10.1016/j.wneu.2022.03.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
The internal carotid artery (ICA) course has been discussed extensively. Several classification systems have attempted to delineate an accurate and helpful trajectory for microsurgical and endoscopic guidance, thus allowing a better neurosurgical performance while avoiding intraoperative complications. Also, the practicality of the classification systems has been emphasized for scholarly communication among disciplines. Nevertheless, the nomenclature of the ICA remains heterogeneous and confusing for health care professionals, trainees, and students. We present an illustrative review of 8 notable ICA classification systems using lateral and anterior views as a rapid tool for neuroanatomic consultation. The appraisal of the vessel anatomy from different perspectives while recognizing their usefulness and limitations might provide a comprehensive understanding of the ICA, optimize the intraoperative performance, and facilitate communication.
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Affiliation(s)
| | - Gokhan Canaz
- Department of Neurosurgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Cvetina Vatcheva
- School of Medicine, Eberhard Karls University of Tübingen, Germany
| | - Jack Wellington
- School of Medicine, Cardiff University, Cardiff, United Kingdom
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