Validation of specially designed and artificial intelligence-based 3D head model for training of Gasserian ganglion puncture
https://doi.org/10.47093/2218-7332.2025.1237
Abstract
Aim. To design, develop and validate a 3D head simulation model for foramen ovale puncture, incorporating computer vision-based artificial intelligence (AI) technologies.
Materials and methods. A 3D simulation model with AI integration was developed in the prototyping laboratory. Its effectiveness for surgical training was evaluated by two groups: neurosurgeons with five or more years of experience (n = 10) and residents (n = 28). Training outcomes were assessed using the following parameters: intervention time, number of puncture attempts until they achieved the first one without any complications, number of complications involving critical anatomical structures. The validity was assessed using a Likert scale.
Results. Before the training session, the groups differed in terms of the time spent on the procedure, the number of puncture attempts and the number of complications involving critical anatomical structures. Post-training intervention time decreased by 50% in both groups, the number of puncture attempts reduced by 50.0% in physicians and by 60.3% in residents. The cumulative number of complications declined by 57.8% in physicians and by 59% in residents. Likert scale analysis revealed no statistically significant differences between groups across all parameters. The feasibility and educational effectiveness of the model were rated as 4 or 5 by 90% of participants in both groups. Anatomical realism received a score of 4 or 5 from 90% of physicians and 100% of residents. Radiographic realism received a score of 4 or 5 from all participants. The cost of creating a simulator, excluding the cost of a 3D printer, was 22,685 rubles.
Conclusion. The developed 3D simulation model with AI integration significantly improved training outcomes both in physicians’ and residents’ groups. The use of standard prototyping equipment provides a cost-effective, radiation-free alternative for widespread implementation in neurosurgical education.
About the Authors
R. A. SufianovRussian Federation
Rinat A. Sufianov, Cand. of Sci. (Medicine), Associate Professor, Department of Neurosurgery; neurosurgeon, Department of Neurooncology
8/2, Trubetskaya str., Moscow, 119048;
24, Kashirskoye Highway, Moscow, 115522
N. A. Garifullina
Russian Federation
Nargiza A. Garifullina, postgraduate student, Department of Neurosurgery; neurosurgeon, Department of Admissions and Advisory; Assistant Professor, Department of Pharmacology
8/2, Trubetskaya str., Moscow, 119048;
5, 4 km of Chervishevskogo trakta str., Tyumen, 625032;
54, Odesskaya str., Tyumen, 625023
A. N. Zyryanov
Russian Federation
Aleksandr N. Zyryanov, engineer
5, 4 km of Chervishevskogo trakta str., Tyumen, 625032
A. D. Zakshauskas
Russian Federation
Anton D. Zakshauskas, engineer
5, 4 km of Chervishevskogo trakta str., Tyumen, 625032
M. F. Chakhmakhcheva
Russian Federation
Margarita F. Chakhmakhcheva, student, Institute of Motherhood and Childhood
54, Odesskaya str., Tyumen, 625023
A. A. Sufianov
Russian Federation
Albert A. Sufianov, Dr. of Sci. (Medicine), Professor, Corresponding Member of the RAS, Head of the Department of Neurosurgery; Chief Physician; Director, Educational and Research Institute of Neurosurgery; Professor, Department of Neurosurgery
8/2, Trubetskaya str., Moscow, 119048;
5, 4 km of Chervishevskogo trakta str., Tyumen, 625032;
6, Miklukho-Maklaya str., Moscow, 117198;
Anarkali, Lahore, 54000, Pakistan
References
1. Thomas W.E. Teaching and assessing surgical competence. Ann R Coll Surg Engl. 2006 Sep; 88(5): 429–432. https://doi.org/10.1308/003588406X116927. PMID: 17002841
2. Sachdeva A.K., Tekian A., Park Y.S., Cheung J.J.H. Surgical skills training for practicing surgeons founded on established educational theories and frameworks. Med Teach. 2024 Apr; 46(4): 556–563. https://doi.org/10.1080/0142159X.2023.2262101. Epub 2023 Oct 9. PMID: 37813106
3. Joshi T., Budhathoki P., Adhikari A., et al. Improving medical education: a narrative review. Cureus. 2021 Oct 14; 13(10): e18773. https://doi.org/10.7759/cureus.18773. PMID: 34804650
4. Koch A., Kullmann A., Stefan P., et al. Intraoperative dynamics of workflow disruptions and surgeons’ technical performance failures: insights from a simulated operating room. Surg Endosc. 2022 Jun; 36(6): 4452–4461. https://doi.org/10.1007/s00464-021-08797-0. Epub 2021 Nov 1. PMID: 34724585
5. Fava A., Gorgoglione N., De Angelis M., et al. Key role of microsurgical dissections on cadaveric specimens in neurosurgical training: Setting up a new research anatomical laboratory and defining neuroanatomical milestones. Front Surg. 2023 Mar 9; 10: 1145881. https://doi.org/10.3389/fsurg.2023.1145881. PMID: 36969758
6. Almeida D.B., Hunhevicz S., Bordignon K., et al. A model for foramen ovale puncture training: Technical note. Acta Neurochir (Wien). 2006 Aug; 148(8): 881–883; discussion 883. https://doi.org/10.1007/s00701-006-0817-2. Epub 2006 Jun 23. PMID: 16791431
7. He Y.Q., He S., Shen Y.X., Qian C. Clinical value of a self-designed training model for pinpointing and puncturing trigeminal ganglion. Br J Neurosurg. 2014 Apr; 28(2): 267–269. https://doi.org/10.3109/02688697.2013.835379. Epub 2013 Sep 7. PMID: 24628215
8. Buyck F., Vandemeulebroucke J., Ceranka J., et al. Computervision based analysis of the neurosurgical scene – A systematic review. Brain Spine. 2023 Nov 7; 3: 102706. https://doi.org/10.1016/j.bas.2023.102706. PMID: 38020988
9. Héréus S., Lins B., Van Vlasselaer N., et al. Morphologic and morphometric measurements of the foramen ovale: comparing digitized measurements performed on dried human crania with computed tomographic imaging. An observational anatomic study. J Craniofac Surg. 2023 Jan-Feb; 34(1): 404–410. https://doi.org/10.1097/SCS.0000000000008996. Epub 2022 Sep 6. PMID: 36197435
10. Topalli D., Cagiltay N.E. Eye-hand coordination patterns of intermediate and novice surgeons in a simulation-based endoscopic surgery training environment. J Eye Mov Res. 2018 Nov 8; 11(6): 1–14. https://doi.org/10.16910/jemr.11.6.1. PMID: 33828711
11. Lasso A., Heffter T., Rankin A., et al. PLUS: open-source toolkit for ultrasound-guided intervention systems. IEEE Trans Biomed Eng. 2014 Oct; 61(10): 2527–2537. https://doi.org/10.1109/TBME.2014.2322864. Epub 2014 May 9. PMID: 24833412
12. Fedorov A., Beichel R., Kalpathy-Cramer J., et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012 Nov; 30(9): 1323–1341. https://doi.org/10.1016/j.mri.2012.05.001. Epub 2012 Jul 6. PMID: 22770690
13. Joshi A., Kale S., Chandel S., Pal D.K. Likert Scale: explored and explained. Curr. J. Appl. Sci. Technol. 2015 Feb 20; 7(4): 396–403. https://doi.org/10.9734/BJAST/2015/14975
14. Cheshire W.P. Trigeminal neuralgia: for one nerve a multitude of treatments. Expert Rev Neurother. 2007 Nov; 7(11):1565–1579. https://doi.org/10.1586/14737175.7.11.1565. PMID: 17997704
15. Peris-Celda M., Graziano F., Russo V., et al. Foramen ovale puncture, lesioning accuracy, and avoiding complications: microsurgical anatomy study with clinical implications. J Neurosurg. 2013 Nov; 119(5): 1176–1193. https://doi.org/10.3171/2013.1.JNS12743. Epub 2013 Apr 19. PMID: 23600929
16. Shakur S.F., Luciano C.J., Kania P., et al. Usefulness of a virtual reality percutaneous trigeminal rhizotomy simulator in neurosurgical training. Neurosurgery. 2015 Sep; 11(3): 420–425; discussion 425. https://doi.org/10.1227/NEU.0000000000000853. PMID: 26103444
17. Hopper A.N., Jamison M.H., Lewis W.G. Learning curves in surgical practice. Postgrad Med J. 2007 Dec; 83(986): 777–779. https://doi.org/10.1136/pgmj.2007.057190. PMID: 18057179
18. Takagi K., Outmani L., Kimenai H.J.A.N., et al. Learning curve of kidney transplantation in a high-volume center: A Cohort study of 1466 consecutive recipients. Int J Surg. 2020 Aug; 80: 129–134. https://doi.org/10.1016/j.ijsu.2020.06.047. Epub 2020 Jul 11. PMID: 32659389
19. Kasatkin V., Deviaterikova A., Shurupova M., Karelin A. The feasibility and efficacy of short-term visual-motor training in pediatric posterior fossa tumor survivors. Eur J Phys Rehabil Med. 2022 Feb; 58(1): 51–59. https://doi.org/10.23736/S1973-9087.21.06854-4. Epub 2021 Jul 12. PMID: 34247471
20. Park C.K. 3D-Printed disease models for neurosurgical planning, simulation, and training. J Korean Neurosurg Soc. 2022 Jul; 65(4): 489–498. https://doi.org/10.3340/jkns.2021.0235. Epub 2022 Jun 28. PMID: 35762226
21. Pucci J.U., Christophe B.R., Sisti J.A., Connolly E.S. Jr. Three-dimensional printing: technologies, applications, and limitations in neurosurgery. Biotechnol Adv. 2017 Sep; 35(5): 521–529. https://doi.org/10.1016/j.biotechadv.2017.05.007. Epub 2017 May 24. PMID: 28552791
22. Dewan M.C., Rattani A., Fieggen G., et al. Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change. J Neurosurg. 2018 Apr 27; 130(4): 1055–1064. https://doi.org/10.3171/2017.11.JNS171500. PMID: 29701548
23. Wong C.E., Chen P.W., Hsu H.J., et al. Collaborative human-computer vision operative video analysis algorithm for analyzing surgical fluency and surgical interruptions in endonasal endoscopic pituitary surgery: cohort study. J Med Internet Res. 2024 Jul 4; 26: e56127. https://doi.org/10.2196/56127. PMID: 38963694
24. Ganni S., Botden S.M.B.I., Chmarra M., et al. A software-based tool for video motion tracking in the surgical skills assessment landscape. Surg Endosc. 2018 Jun; 32(6): 2994–2999. https://doi.org/10.1007/s00464-018-6023-5. Epub 2018 Jan 16. PMID: 29340824
25. Danilov G., Kostyumov V., Pilipenko O., et al. Computer vision for assessing surgical movements in neurosurgery. Stud Health Technol Inform. 2024 Aug 22; 316: 934–938. https://doi.org/10.3233/SHTI240564. PMID: 39176945
26. Ciporen J., Lucke-Wold B., Dogan A., et al. Dual endoscopic endonasal transsphenoidal and precaruncular transorbital approaches for clipping of the cavernous carotid artery: A cadaveric simulation. J Neurol Surg B Skull Base. 2016 Dec; 77(6): 485–490. https://doi.org/10.1055/s-0036-1584094. Epub 2016 May 24. PMID: 27857875
27. Kashapov L.N., Kashapov N.F., Kashapov R.N., Pashaev B.Y. The application of additive technologies in creation a medical simulator-trainer of the human head operating field. IOP Conf Ser: Mater Sci Eng. 2016; 134: 012011. https://doi.org/10.1088/1757-899X/134/1/012011
28. Santona G., Madoglio A., Mattavelli D., et al. Training models and simulators for endoscopic transsphenoidal surgery: A systematic review. Neurosurg Rev. 2023 Sep 19; 46(1): 248. https://doi.org/10.1007/s10143-023-02149-3. PMID: 37725193
29. Xu Y., El Ahmadieh T.Y., Nunez M.A., et al. Refining the anatomy of percutaneous trigeminal rhizotomy: A cadaveric, radiological, and surgical study. Oper Neurosurg. 2023 Apr 1; 24(4): 341–349. https://doi.org/10.1227/ons.0000000000000590. Epub 2023 Jan 23. PMID: 36716051
30. James J., Irace A.L., Gudis D.A., Overdevest J.B. Simulation training in endoscopic skull base surgery: A scoping review. World J Otorhinolaryngol Head Neck Surg. 2022 Mar 31; 8(1): 73–81. https://doi.org/10.1002/wjo2.11. PMID: 35619934
31. Mayol Del Valle M., De Jesus O., Vicenty-Padilla J.C., et al. Development of a neurosurgical cadaver laboratory despite limited resources. P R Health Sci J. 2022 Sep; 41(3): 153–156. PMID: 36018744
Supplementary files
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1. Supplement А. A circuit diagram of the 3D head model operation based on the ARDUINO microcontroller. | |
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2. Supplement B. Calculation of the cost of making a 3D model of the head. | |
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3. Supplement C. Video demonstrating how to practice the puncture of the foramen ovale. | |
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