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The purpose of the use of virtual reality technology reconstruction of sellar tumors anatomical structure, through observation build anatomic images of tumor model building methods and improvements; tumor model in the actual surgery with intraoperative image contrast. Comparing the actual surgery seen through observation model sellar tumors, pituitary adenoma, described the flag of the virtual reality environment Endonasal - sphenoid sinus anatomy-oriented approach, and surgical simulation process based on observations; summarize model assisted identification of anatomical structures, explore its assessment of the value of this approach surgery. Collected 60 cases diagnosed by MRI in patients with sellar tumors, preoperative thin layer of CT, MRI scan, the scan data import Dextroscope image workstation, segmentation, and reconstruction of the sella, carotid artery, Willis circle and its branches, the optic nerve and the anatomical structure of the optic chiasm, brain tissue and soft tissue surgical approach to a variety of saddle area, compared with the anatomic relationship seen in the actual surgery simulation based on the observed results. Model based on a detailed study of 30 patients with pituitary adenoma model, observation of anatomic landmarks and tumor characteristics, analog Endonasal - transsphenoidal. Finally, surgery, surgical principles and observations simultaneous contrast seen in virtual surgery. 1 all sellar tumor model can be clearly displayed three-dimensional bone and internal carotid arteries, Willis ring and branch, optic nerve and chiasm, ventricular system, tumor tissue, brain tissue and soft tissue and other anatomical structures adjacent relationship. Excellent effect compared to other three-dimensional reconstruction images can be random angles and the azimuth observations surgical approach appropriate anatomic landmarks. 2. Required to build the model image sequence must be thin sectional images, including CT skull and skin, CTA for cerebrovascular, MRI-T1WI brain tissue, the optic nerve and the ventricular system, MRI-T1WI contrast enhanced sequence for tumor tissue image extract fine. Anatomic landmarks and surgical clearance through virtual tools can simulate the craniotomy, tumor resection operation can also simulate the surgical field revealed angle and range, to master the technique to protect the optic nerve, Willis ring, third ventricle and brainstem The structure of the program. 4 the transsphenoidal surgery in pituitary adenoma model simulation endonasal - specific applications, columella marked, measuring nasal septum bone cartilage Ministry, the sphenoid opening the distance, measured anterior nostril plane point to the sphenoid sinus anterior wall of the shallowest point distance. Marked lower edge to the sphenoid sinus openings, measurement and sphenoid top wall, under the wall, the lateral wall of the upper edge of the choanal and sellar distance of. Marked sellar measuring distance with carotid cavernous segment, optic canal, saddle nodules and saddleback. Columella - the glabella connection and into the path line angle were measured. VR environment approach perspective, observed nasal septum, butterfly crest, sphenoid sinus openings, the sphenoid cavity sellar positioning guide signs, assess the individual anatomy and tumor characteristics, and successfully simulated surgery, with contrast to the actual surgery, intraoperative findings consistent with preoperative simulation. Conclusion 1. Using virtual reality technology for model building, built a realistic, three-dimensional image, the additional three-dimensional anatomical information is available for patients who make up for the lack of two-dimensional cross-sectional images and judge for preoperative tumor adjacent sellar tumors anatomic variations and approach help. Image workstations provide in Dextroscope virtual instrument model repeated drills surgical operation, without any harm to the patient. Through repeated simulations can explore the considerations and operating points of the actual surgery. Compared with conventional two-dimensional cross-sectional images, three-dimensional image of the model to simplify the the surgeon thinking process, is planning an effective complement to conventional clinical surgery. 3 of all sellar tumor model in the VR environment supports undisturbed recovery, although it can not reach the actual effect of the cadaver specimens, but still show the gross anatomy of the sellar region morphology, especially pathological learning saddle area for young physicians to provide pathology anatomy and surgical aids, medical students are no longer limited to conventional books, teaching materials and animal models, to expand the scope of education and training. 4 stereo viewing turbinate, nasal septum, sphenoid sinus anterior wall butterfly crest, sphenoid septum and sellar anatomical position, looking for individual anatomical guide signs, such as butterfly crest, the sphenoid sinus openings sellar midpoint avoid straying into the surrounding tissue structure damage. VR environment through stereoscopic observation sphenoid mouth sellar tumor tissue anatomy can master the sphenoid sinus anterior wall and the sellar individual fenestration range, the tumor resection azimuth, to avoid damage to important anatomical structures .
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