Date
6-17-2026
Department
School of Health Sciences
Degree
Doctor of Philosophy in Anatomy & Cell Biology (PhD)
Chair
Ben Kalu
Keywords
Craniotomy, cadaveric dissection, atlanto-occipital, occipital wedge, brain, Anatomical, Preservation, Prosections, Education, Brain removal, Cranial cavity, Cranial nerves, Cranial arteries, Dura venous sinus, Brainstem, Foramen magnum
Disciplines
Anatomy | Medicine and Health Sciences
Recommended Citation
Donkor, Yaw Otchere, "Atlanto-Occipital Approach for Cadaveric Craniotomy: Preserving the Skull, Maintaining Integrity of the Brain, Cranial Nerves, and Blood Vessels for Anatomical Education" (2026). Doctoral Dissertations and Projects. 8584.
https://digitalcommons.liberty.edu/doctoral/8584
Abstract
Background: Cadaveric dissection is the foundation teaching and learning anatomy. This provides students with a practical hands on as their “first patients and surgical skills. Scarcity of cadavers has led to the conceptualization of techniques that maximize preservation of vital organs for future use. Limited cadaver due to cultural beliefs affecting body donating programs especially in Africa, rapid increase of new medical schools, However, craniotomy dissection techniques present significant challenges, as harvesting an intact brain block with cranial nerves and skull bones from human cadavers is technically complex and impractical for teaching and research purposes. Aim: Aim of this study is to evaluate three different craniotomy approaches traditional, occipital wedge, and the proposed novel atlanto occipital technique to determine the most effective method for brain removal. The assessment focuses on procedural efficiency, preservation of skull topography and maintaining the integrity of key brain structures for educational and scientific research purposes. Methodology: A total of 45 cadavers were used in the study, obtained through a convenience sampling method and comprising 23 males and 22 females aged between 70 and 100 years. Fifteen cadavers were assigned to each of the three brain removal approaches: traditional, occipital wedge, and atlanto occipital. The study was conducted at Liberty University within the Department of Biology and Chemistry, School of Health Sciences, and the Liberty University College of Osteopathic Medicine (LUCOM). All procedures adhered to Cadaver Laboratory Policy and ethical guidelines, ensuring that specimens were handled with care and treated with dignity and respect throughout the research process. Standard dissection instruments were utilized to ensure precision and compliance during brain removal and anatomical examination. The three approaches were applied following detailed step by step protocols for brain removal, which served as the basis for data collection. The parameters considered to achieve the aim of the study were grouped into preservation specifically of the brain, cranial nerves, dura matter, skull, and blood vessels (selected arteries and veins of the brain) and procedural efficiency and time effectiveness. Data analysis was performed using one way ANOVA, followed by post hoc Tukey–Kramer multiple comparison tests to assess statistical significance. Results and Discussion: The results demonstrated notable differences among the three approaches in both procedural efficiency and preservation outcomes. Time estimates for brain removal showed mean total times of 811.93 s ± 203.39 for the traditional approach, 1247.48 s ± 253.57 for the occipital wedge, and 967.05 s ± 114.57 for the atlanto occipital approach, with a statistically significant difference (P = 0.000177, F = 18.46). The longest duration is due to the additional steps involved, particularly during calvarium removal. Gross examinat
