2011 AANS Annual Report - page 7

Neurosurgical anatomy is perhaps the most difficult subject for
neurosurgical residents to master. Physicians are indoctrinated
into the intricacies of the specialty by attending lectures or
witnessing a procedure being conducted in an OR. But once the
doctor leaves the anatomy lab or the operating room, they again
are faced with the task of learning anatomy in the traditional,
two-dimensional format of textbooks.
However, with the development of 3D-television technology,
Jeffrey M. Sorenson, MD, FAANS, got the idea that perhaps
there was a better way to view and understand anatomy. A
series of lectures was needed in a video format that would help
accelerate the learning process. And what better source than
the three-dimensional anatomy presentations of former AANS
president Albert L. Rhoton Jr., MD, FAANS, who pioneered the
use of stereoscopy in his lectures. That was the impetus behind
the creation of The Rhoton Collection.
“There were times when I attended lectures by Dr. Rhoton
where I wished I could dwell on one slide for 20 minutes, or
rewind it to look at something again after the lecture had moved
on,” said Dr. Sorenson. “We needed to develop a way to get Dr.
Rhoton’s lectures archived so that surgeons could study on their
own time, but in a high-resolution stereoscopic format. When 3D
TVs came out, that was the tipping point.”
At the time, Jon Robertson, MD, FAANS; and William Couldwell,
MD, PhD, FAANS, were discussing with Dr. Rhoton the need
for such a project, which would be sponsored by the AANS.
After Dr. Rhoton agreed to participate, four initial lectures —
Cerebellopontine Angle and Fourth Ventricle; Cavernous Sinus
and Middle Fossa; Far Lateral Approach and Jugular Foramen;
and Navigating the Temporal Bone — were prepared.
Since Dr. Rhoton’s live presentations were based upon multiple
projectors and a silver screen, there were technical challenges
in reformatting the lectures for 3D-television viewing. These
were solved with a variety of software tools used to prepare
the images to look their best on a 3D television; video-editing
software; and a web-based database developed by Dr. Sorenson
that also will serve as the foundation of an interactive online
neuroanatomy textbook. Dr. Sorenson started with recordings
of Dr. Rhoton’s lectures, in which Dr. Rhoton would use a laser
pointer to highlight a particular area or structure. Instead
of trying to simulate a laser pointer, Dr. Sorenson created
anatomical drawings over the digital photographs to highlight
each structure Dr. Rhoton referred to. Because stereoscopy
directs separate images to both the left and right eye, thousands
of drawings were required.
“It was technical work, but it was artistic, too,” said Dr.
Sorenson. “We’re presenting works of art in these lectures.”
Another obstacle in the creative process was adding an audio
element to the visual presentation. To accomplish this, Dr.
Sorenson used live audio recordings from Dr. Rhoton’s lectures
and then synchronized that audio to the presentation. “It gives
the viewer a full understanding what it is like to attend one of
his lectures, which was so important,” said Dr. Sorenson. “But
the most daunting challenge was to live up to the high standards
Dr. Rhoton sets for his own work.”
The Rhoton Collection 3D videos are available not only on Blu-
ray DVD, but via the AANS’ site on iTunes U, as well — the first
such 3D offerings available. “We always want to try to raise the
bar for neurosurgical teaching,” said Dr. Sorenson. “It is a real
privilege to work with Dr. Rhoton and see how dedicated he is to
education. Through patience and perseverance, he’s taken years
to develop these extraordinary lectures. That’s why I was happy
to hear him say he was pleased with the end result.”
Dr. Sorenson is an Assistant Professor in the Department of
Neurosurgery at the University of Tennessee, where he completed
his neurosurgical residency, and is a member of the Semmes-
Murphey Clinic.
Bringing Neurosurgical Anatomy into a New Dimension
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