• Kosuke Kondo, Masaaki Nemoto, Naoyuki Harada, Hiroyuki Masuda, Syunpei Ando, Shuuhei Kubota, and Nobuo Sugo.
• Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Ota-ku, Tokyo, Japan.
• World Neurosurg. 2019 Jul 1; 127: e609-e616.

BackgroundThe combined transpetrosal approach is a complicated skull base surgery with a high degree of difficulty. Herein, we made a 3-dimensional (3D) printed petrous bone with color-coded anatomic sites and evaluated its usefulness as a model to practice drilling associated with combined transpetrosal surgery.MethodsTo design a 3D model of the petrous bone, we chose a representative epidermoid petroclival tumor case who underwent combined transpetrosal surgery at our hospital. A 3D image of the petrous bone embedded with color-coded anatomic sites, including cranial nerves, brainstem, and internal carotid and vertebrobasilar arteries, was created based on preoperative computed tomography scan, magnetic resonance, and digital subtraction angiography images and was then 3D printed. Thirteen neurosurgeons from our department evaluated the anatomic reproducibility and estimated distance between each anatomic site of the 3D image and model and the usefulness of the model for drilling practice.ResultsThe anatomic reproducibility of both the 3D image and model was high, and the 3D model was considered good for drilling practice (P < 0.05). The error in the estimated distance between anatomic sites in the 3D model was significantly smaller than that of the 3D image (P < 0.0001).ConclusionsThese results indicate that our 3D printed model is very useful for practice with craniotomy and petrosectomy drilling, necessary in the combined transpetrosal approach.Copyright © 2019 Elsevier Inc. All rights reserved.

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