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Background: Success in transcranial microsurgery and endoscopic skull base surgery is predicated on one’s knowledge in surgical neuroanatomy. While graphic depictions aim to present the 3D anatomy, technical skills must be developed through hands-on practice. To address this, a dedicated microsurgical neuroanatomy laboratory—the first of its kind in Indiana—was established in 2025 at the Indiana University School of Medicine. Led by the senior author, the lab promotes surgical artistry through anatomical precision, repetition, and interdisciplinary collaboration. The objective of this study is to describe the inception and collaborative development of a skull base lab at Indiana University.
Methods: The lab has been supported through personal funds and industry support. As a joint effort between the Departments of Neurological Surgery and Otolaryngology, fellows were selected from an international pool of applicants. Each fellow received a latex-injected, alcohol-preserved head and had full access to complete neurosurgical equipment, Mayfield headrests, endoscopes, microscopes, drills, aspirators, and professional photography equipment. Daily dissections followed a stepwise approach, with each step captured by high-resolution 2D/3D images and photogrammetry. Media acquired from the lab was later combined with surgical videos so that the understanding of the microsurgical anatomy can be translated into the operating room. Weekly neuroanatomy meetings were also held to foster peer learning and mentorship.
Results: In its first year, the lab is set to train seven international fellows, with fellowships ranging from 3-12 months. The overlapping time period between the fellows facilitates international dissemination of ideas and techniques. Dissections encompassing open and endoscopic skull base approaches of the anterior, middle, and posterior fossa were performed. The present fellows report significant improvements in 3D orientation, technical confidence, and surgical fluency.
Conclusion: The IU microsurgical neuroanatomy lab offers a transformative and internationally collaborative model for neurosurgical education. The lab merges anatomical precision, simulation, and mentorship to prepare the next generation of neurosurgeons.
