Abstract：Objective To discuss microanatomy features of internal auditory canal through suboccipito-retrosigmoidal minimally invasive approach based on virtual reality image model.Methods CT and MRI scans were performed on fifteen adult cadaver heads, and then, image data were input into Vitrea virtual reality system to establish three-dimensional anatomy model of internal auditory canal and surrounding structures. Different minimally invasive road of suboccipito-retrosigmoidal approaches for drilling of surgical targets in internal auditory canal were simulated by selecting osseous landmark points on the calvaria and skull base. Changes of anatomy exposures were observed, measured and compared following alternation of surgical roads.Results Spacial sequence of nerves and vessels in the route simulating suboccipito-retrosigmoidal approach for drilling internal auditory canal was displayed distinctly. Measurement and comparative analysis showed that volumes of osseous structure and labyrinth involved in route a were the most, and then, volumes involved in route b were more than those in route c. Cerebellar involved in route b was the most, and then, volume of cerebellar involved in route c was more than that in route a. Facial-acoustic nerve complex involved in route b was the most, and then, volume of facial-acoustic nerve complex involved in route a was more than that in route c. The differences of above items reached statistically significant diffecence.Conclusions Assisted by computed virtual reality skill, quantitative evaluation of invasion and target exposure in simulative routes of suboccipito-retrosigmoidal approach drilling petrous bone and reaching terminal of internal auditory canal can be performed to guide minimally invasive surgical practice.
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2016, Vol. 27 
