The Johns Hopkins Virtual Sinus Simulator (JHViSS) is an interactive desktop application that uses 3D models to help medical students and junior residents explore the anatomy of the sinuses and skull base, and understand key surgical relationships.

The app incorporates 3D schematic models of the following:

• Right-sided nasal cavity
• Maxillary sinus
• Ethmoid cavity
• Sphenoid sinus and surrounding structures

JHViSS was built in Unity using Cinema 4D R23. Segmented and reconstructed 3D CT renderings were taken of a patient with a planum meningioma. Surgical videos from the patient’s operation are also included.

JHViSS was developed by Anirudh Saraswathula, M.D., resident in the Johns Hopkins Department of Otolaryngology–Head and Neck Surgery, and Shirley Li, M.A., graduate student in the Johns Hopkins Department of Art as Applied to Medicine, with guidance from faculty members Nicholas Rowan, M.D., and Juan Garcia, M.A.

App Download

Installation Instructions (Mac)

• Download the package on a desktop computer and double click on the app to start.
• In Mac OS, apps not downloaded from the App Store may be disabled by system security. To enable JHViSS, navigate to System Settings > Privacy & Security > Security. This only needs to be done before the first use.
• To quit the app on Mac, press command-Q.
• Download JHViSS for Mac (~673 MB)

Installation Instructions (Windows)

• Download the package and extract the ZIP file to your Downloads folder. Then double-click on “JHViSS.exe” to start the app.
• Make sure the app stays in the same folder as the supporting files in the JHViSS Windows folder.
• Your PC may ask you if you want to allow the app to run since it’s from an unidentified developer, and you should agree. This only needs to be done before the first use.
• Download JHViSS for Windows (~664 MB)

App Instructions and Features

Explore Mode vs. Clinical Mode

Explore Mode allows you to interact with the anatomy at all angles, and includes four panels:

• Schematic view (top left) shows a schematized view of the sinonasal cavity designed to highlight the relationships between structures.
• 3-D reconstructed view (bottom left) shows an anatomically accurate 3D reconstruction of the sinonasal cavity, sinuses and skull base (excluding the frontal sinus).
• Coronal (top right) and axial (bottom right) CT images show the patient’s CT imaging and correlate with the 3D model displayed in the bottom left.

Clinical Mode shows operative video for maxillary antrostomy and anterior ethmoidectomy, limiting the angle of view in the schematic model to what would be seen in the operating room. To activate Clinical Mode, select the toggle switch in the top left of the app.

3D Model Interaction Controls

• Rotate image: Left-click and drag.
• Pan image: Right-click and drag.
• Zoom: Scroll up (zoom out) and down (zoom in).
• Highlight structures in all models: Click on the structure’s name in the left-hand sidebar to highlight it in red in the 3D models as well as on the CT images.
• Hide structures in 3D models: Uncheck the box on the structure’s name in the left-hand sidebar.
• Toggle image plane: In the top-right corner of the 3D reconstructed image panel, click on the box labeled “Ax. plane” or “Cr. plane” to toggle the plane showing the location of the displayed CT image.

CT Image Interaction Controls

• Scroll through CT image: Use the slider to the left of the image.
• Pan image: Left-click and drag.
• Zoom: Scroll up (zoom out) and down (zoom in).
• Highlighted structures: Note that structures highlighted in the left-hand sidebar will be highlighted in the CT images as well.