Stereotactic Step-by-step Dissection of the Anterior Transpetrosal Approach: A Three-dimensional Photogrammetry-based Educational Tool for Neurosurgeons

Skull base surgery requires precise spatial recognition; however, existing educational tools remain limited. To address this issue, we developed a step-by-step stereotactic three-dimensional anatomical model of the anterior transpetrosal approach using digital photogrammetry. Cadaveric dissection was subsequently performed in 17 steps, of which 10 were reconstructed into three-dimensional models. The images were processed using 3DF Zephyr and Blender to create interactive three-dimensional portable document-format models, enabling dynamic anatomical visualization. The three-dimensional models provided high-resolution visualization of the complex skull base structures, including the trigeminal nerve, trochlear nerve, geniculate ganglion, semicircular canal, and internal carotid artery. Additionally, they supported keyhole surgery simulations by allowing users to manipulate and explore anatomical structures from multiple perspectives. However, the compatibility and performance varied depending on the device and software used. This study demonstrated the feasibility of a three-dimensional photogrammetry-based educational tool for skull base anatomy. By providing interactive three-dimensional visualization, this tool may complement existing surgical training methods and enhance anatomical understanding. However, further studies are required to evaluate its practical impact in structured educational settings.