A virtual laboratory for temporal bone microanatomy

(cavities), canals, and fissures. Crucial nerves, blood vessels, and auditory and vestibular organs coexist in this dense bone structure in a complex 3D configuration , causing medical science to once regard the temporal bone as a surgically forbidden area (see Figure 1). Today, otolaryngology (ear, nose, and throat) surgeons still find it difficult to envision and master these complex anatomic interrelationships. The stapes, for example, is one of the three bones in the middle ear. These bones transmit sound vibrations from the tympanic membrane to the inner ear. In a disease called otosclero-sis, the stapes becomes fixed and doesn't transmit sound efficiently. A stapedectomy is a procedure that removes the top part of the stapes, drills a hole in the stapes footplate, and places a prosthesis 0.6 mm through the footplate to transmit sound. This pros-thesis, a small column approximately 0.5 mm in diameter, must not touch the utricle or saccule; if it does, there is a high risk of postoperative deafness. An otolaryngologist can perform a stapedectomy successfully only when he or she is familiar with the 3D relationship among these tiny structures. Learning temporal bone mi-croanatomy is one of an otolaryngol-ogy resident's most important and problematic tasks. Traditionally, the process involves anatomic description, illustrations, photographs, histological (minute structures) and gross sections, computerized tomography (CT) and magnetic resonance imaging (MRI) scans, sculpted specimens, and, finally, cadaver dissection and operating room surgical procedure observation. It takes intensive study spanning hundreds of hours and many laboratory trial-and-error efforts before an otolaryngology resident is confident enough to begin drilling in the operating room. Equipping a traditional temporal bone laboratory equipped with operating tables, operating microscopes, high-speed otologic drills, and otologic microinstruments is very expensive. 1,2 Moreover, human temporal bone specimens taken from individuals who have donated their bodies to the hospital are not easy to get for training or study. Even with such tools, otolaryngology surgeons won't have all the important 3D structural relationships simultaneously and interactively. Here, we present a new method for generating and reconstructing 3D temporal bone models and their applications in stereoscopic virtual environments. Our virtual laboratory and its associated software can run on ordinary PCs. In recent years, computer-generated 3D temporal bone models have proven their potential to be the ideal teaching or study aid. Several authors have published different CT-scan-based 3D temporal bone models and virtual surgery simulations for training. 3–5 However, CT-scan-based 3D models are …