134 - Dissection of the brain using the Klingler methodology by medical students and neurosurgery residents

Poster Board Number: 134
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Co-authors:

Susana Maria Silva - Professor, Biomedicine, Unit of Anatomy, Faculty of Medicine of University of Porto

Abstract Body : The spatial relationship between white matter fiber tracts is challenging to visualize in the brains ordinarily present in the anatomy laboratory. The Klingler methodology allows the isolation and visualization of the white matter fibers, providing a three-dimensional understanding of the structure of these fibers and their relation with the gray matter and the ventricular system.

This work aims to show the value of applying the Klingler technique performed by medical students and neurosurgery residents, evaluating their perceptions after dissecting and observing the brains.

Several formalin-fixed brains from donors were dissected using the Klingler methodology by 12 Medical students and 35 Neurosurgery residents in the scope of an optional chair of the medical curriculum of the Faculty of Medicine of Porto, Portugal (Functional Neuroanatomy) and a brain dissection course (Human Brain Dissection and Neuroanatomy) for neurosurgery residents of the first years from several hospitals of Portugal. Hand-made wooden spatulas were used to expose the major fiber tracts and to avoid artifacts and damage during the procedure. A 5-single item Likert-type survey was prepared to assess the subjective opinion about brain dissection and its importance in educational and clinical contexts.

The students and neurosurgery residents rated the dissection experience as highly positive, leading to a better understanding of the three-dimensional structure of the brain and the visualization of the white matter system of fibers.

The Klingler dissection technique is an excellent method for the dissection of the internal brain structures, allowing the observation of the fiber tracts and characterizing their orientation, depth, and relation to gray matter structures and the ventricular system. Students and neurosurgery residents were highly positive and indicated that performing the dissection increased their perception of the white matter system and the three-dimensional perspective of the structure of the brain. Neurosurgery residents considered the experience beneficial for their training when planning the surgical trajectory. In fact, the knowledge of the location of white matter tracts was deemed essential to help minimize the occurrence of postoperative deficits.

Performing brain dissections using the Klinger technique seems to improve both the neuroanatomical knowledge of the brain structure and the experience and skills from practice to training neurosurgery residents and medical students.