Immersive Virtual Reality as an Educational Tool for Skull Base Surgical Training: Development and Initial Implementation of a High-Fidelity 3D Model Library

Introduction: Surgical training for complex skull base approaches has traditionally relied on cadaveric dissection, which is resource-intensive and offers limited opportunities for rehearsal. While 3D anatomical models have emerged as valuable supplements, they often lack immersive, interactive depth. This project describes the development and initial implementation of a novel virtual reality (VR) system designed to provide an immersive, risk-free environment for mastering endoscopic endonasal, orbital, and transcranial surgical approaches to the skull base. Methodology: A comprehensive library of over 200 high-fidelity 3D anatomical models was created using 3D photogrammetry. This process involved stitching together 3,000–4,000 photographs per cadaveric specimen to generate precise, scalable digital reconstructions of actual surgical dissections. These models were integrated into an immersive VR platform. The system allows trainees to navigate step-by-step through surgical corridors, manipulate critical neurovascular structures, and visualize complex anatomical relationships in three-dimensional space. The VR tool was piloted and evaluated during the State-of-the-Art Endoscopic Skull Base Surgery dissection course. Results: The VR educational tool received overwhelmingly positive feedback from attending neurosurgeons, otolaryngologists, and skull base surgeons. Participants praised its dynamic and intuitive interface, highlighting its ability to bridge the gap between traditional dissection and real-world surgical application. Key benefits identified included enhanced understanding of 3D anatomical relationships, the ability to rehearse approaches repeatedly in a risk-free environment, and improved confidence in procedural planning. The immediate educational value was deemed significant, with strong potential to standardize and improve the efficacy of surgical training. Conclusion: The successful implementation of this immersive VR system demonstrates a transformative potential in surgical education. It provides a scalable, accessible, and highly effective method for training current and future surgeons in complex skull base techniques. Future work will focus on refining interactivity, expanding the model library, and quantitatively assessing its impact on surgical performance and long-term patient outcomes. This platform represents a significant advancement toward standardizing and enhancing surgical training. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany