Skull base training and education using an artificial skull model created by selective laser sintering

Practicing skull base approaches on cadavers affords the surgeon a chance to learn complex anatomical relationships and to practice surgical skills. However, there are ethical or legal problems in obtaining cadaver material in some countries. In addition, there is always risk of transmitting infections with cadaveric material. In order to get around these problems, we created a whole skull model which reproduces the detailed anatomy within the skull base using a selective laser sintering (SLS) technique. The first author's head was scanned using multidetector-row computed tomography. The data were reconstructed and converted into the standard triangulation language file system. Powdered material comprised of polyamide nylon and glass beads was laser-sintered in accord with the data derived from the head CT. The model was dissected under a surgical microscope using a high-speed drill, suction, and other surgical instruments. The appearance of both inner and outer cranial surfaces, including sutures, foramens, fissures, and protrusions, were clearly demonstrated. The artificial mastoid did not melt from the heat of the drill when a mastoidectomy was performed. The anatomical structures inside the mastoid and of paranasal sinuses were accurately reproduced in the model. The model created using SLS should be very useful for the teaching skull base approaches avoiding the ethical, legal, and infection problems inherent in cadavers.