Development of an Experimental Model for Studying the Nasosinusal and Skull Base Arterial and Venous Systems Using Iodinated Contrast and Latex in Cadavers.

Livia Castellari Burchianti, Ricardo Landini Lutaif Dolci, Jamile Lopes de Souza, Henrique Bortot Zuppani, Lucas Carvalho Santos, Lucas Araújo Mendes, Mirna Duarte Barros, Carlos José Lazzarini Mendes, Américo Rubens Leite Dos Santos, Paulo Roberto Lazarini

Journal: World neurosurgery 2020;139():e98-e112

PMID: 32272273

Abstract

BACKGROUND

Cadaver dissection remains one of the most reliable and safest ways to study anatomy, whereas computed tomography angiography (CTA) is an essential technology for enabling students to become familiar with human anatomy and surgical planning. Thus, the convergence of both radiologic and anatomic information is important for surgical success, especially in regions of complex anatomy such as the nasosinusal and skull base regions. Here we propose an experimental model in formalinized cadaver heads consisting of intravascular injection of colored latex and iodinated contrast mixture, followed by CTA scans of the nasosinusal and skull base arterial and venous systems before dissection.

METHODS

Six cadaver heads that had been preserved for >5 years in 10% formaldehyde were immersed for 72 hours in a solution containing a dimethyldiethanol mono/dialkyloyl ester quaternary ammonium salt. In 5 of these heads, a mixture composed of latex, tissue ink, and iodinated contrast (Ultravist 300) was injected into the vascular system. CTA scans were performed sequentially after the injection, followed by endonasal and macroscopic dissections.

RESULTS

There was good radiologic and macroscopic vessel uptake in 4 specimens, allowing a detailed anatomic study.

CONCLUSIONS

An experimental model was made feasible by injecting iodinated contrast and colored latex into formalinized cadavers for CTA evaluation of the nasosinusal and skull base arterial and venous systems before performing dissections.

Copyright © 2020 Elsevier Inc. All rights reserved.

Address: Department of Otorhinolaryngology, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo/SP, Brasil. Electronic address: [email protected].; Department of Otorhinolaryngology, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo/SP, Brasil.; Department of Radiology, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo/SP, Brasil.; Department of Morphology, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo/SP, Brasil.; Neurosurgery Discipline, Department of Surgery, Irmandade da Santa Casa de Misericórdia de São Paulo, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo/SP, Brasil.
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