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sEVD-smartphone-navigated placement of external ventricular drains.

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BORIS DOI
10.7892/boris.137427
Date of Publication
March 2020
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Author
Eisenring, Christian
Universitätsklinik für Neurochirurgie
Burn, Felice
Baumann, Michelle
Stieglitz, Lennart H.
Kockro, Ralf A.
Beck, Jürgen
Universitätsklinik für Neurochirurgie
Raabe, Andreas
Universitätsklinik für Neurochirurgie
Oertel, Markus F.
Subject(s)

600 - Technology::610...

Series
Acta neurochirurgica
ISSN or ISBN (if monograph)
0001-6268
Publisher
Springer Vienna
Language
English
Publisher DOI
10.1007/s00701-019-04131-9
PubMed ID
31761975
Uncontrolled Keywords

App External ventricu...

Description
BACKGROUND

Currently, the trajectory for insertion of an external ventricular drain (EVD) is mainly determined using anatomical landmarks. However, non-assisted implantations frequently require multiple attempts and are associated with EVD malpositioning and complications. The authors evaluated the feasibility and accuracy of a novel smartphone-guided, angle-adjusted technique for assisted implantations of an EVD (sEVD) in both a human artificial head model and a cadaveric head.

METHODS

After computed tomography (CT), optimal insertion angles and lengths of intracranial trajectories of the EVDs were determined. A smartphone was calibrated to the mid-cranial sagittal line. Twenty EVDs were placed using both the premeasured data and smartphone-adjusted insertion angles, targeting the center of the ipsilateral ventricular frontal horn. The EVD positions were verified with post-interventional CT.

RESULTS

All 20 sEVDs (head model, 8/20; cadaveric head, 12/20) showed accurate placement in the ipsilateral ventricle. The sEVD tip locations showed a mean target deviation of 1.73° corresponding to 12 mm in the plastic head model, and 3.45° corresponding to 33 mm in the cadaveric head. The mean duration of preoperative measurements on CT data was 3 min, whereas sterile packing, smartphone calibration, drilling, and implantation required 9 min on average.

CONCLUSIONS

By implementation of an innovative navigation technique, a conventional smartphone was used as a protractor for the insertion of EVDs. Our ex vivo data suggest that smartphone-guided EVD placement offers a precise, rapidly applicable, and patient-individualized freehand technique based on a standard procedure with a simple, cheap, and widely available multifunctional device.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/184930
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FileFile TypeFormatSizeLicensePublisher/Copright statementContent
Eisenring2019_Article_SEVDSmartphone-navigatedPlacem.pdftextAdobe PDF3.8 MBpublishedOpen
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