Accuracy of robot-assisted versus optical frameless navigated stereoelectroencephalography electrode placement in children

2019 ◽  
Vol 23 (3) ◽  
pp. 297-302 ◽  
Author(s):  
Julia D. Sharma ◽  
Kiran K. Seunarine ◽  
Muhammad Zubair Tahir ◽  
Martin M. Tisdall
Keyword(s):  
Soft Tissue ◽  
Entry Point ◽  
Electrode Placement ◽  
Target Point ◽  
Localization Error ◽  
Bone Thickness ◽  
Tissue Thickness ◽  
Robot Assisted ◽  
Soft Tissue Thickness ◽  
Safety Margins

OBJECTIVEThe aim of this study was to compare the accuracy of optical frameless neuronavigation (ON) and robot-assisted (RA) stereoelectroencephalography (SEEG) electrode placement in children, and to identify factors that might increase the risk of misplacement.METHODSThe authors undertook a retrospective review of all children who underwent SEEG at their institution. Twenty children were identified who underwent stereotactic placement of a total of 218 electrodes. Six procedures were performed using ON and 14 were placed using a robotic assistant. Placement error was calculated at cortical entry and at the target by calculating the Euclidean distance between the electrode and the planned cortical entry and target points. The Mann-Whitney U-test was used to compare the results for ON and RA placement accuracy. For each electrode placed using robotic assistance, extracranial soft-tissue thickness, bone thickness, and intracranial length were measured. Entry angle of electrode to bone was calculated using stereotactic coordinates. A stepwise linear regression model was used to test for variables that significantly influenced placement error.RESULTSBetween 8 and 17 electrodes (median 10 electrodes) were placed per patient. Median target point localization error was 4.5 mm (interquartile range [IQR] 2.8–6.1 mm) for ON and 1.07 mm (IQR 0.71–1.59) for RA placement. Median entry point localization error was 5.5 mm (IQR 4.0–6.4) for ON and 0.71 mm (IQR 0.47–1.03) for RA placement. The difference in accuracy between Stealth-guided (ON) and RA placement was highly significant for both cortical entry point and target (p < 0.0001 for both). Increased soft-tissue thickness and intracranial length reduced accuracy at the target. Increased soft-tissue thickness, bone thickness, and younger age reduced accuracy at entry. There were no complications.CONCLUSIONSRA stereotactic electrode placement is highly accurate and is significantly more accurate than ON. Larger safety margins away from vascular structures should be used when placing deep electrodes in young children and for trajectories that pass through thicker soft tissues such as the temporal region.

scholarly journals Stereoelectroencephalography

Neurosurgery ◽  
2012 ◽  
Vol 72 (3) ◽  
pp. 353-366 ◽  
Author(s):  
Francesco Cardinale ◽  
Massimo Cossu ◽  
Laura Castana ◽  
Giuseppe Casaceli ◽  
Marco Paolo Schiariti ◽  
...  
Keyword(s):  
Interquartile Range ◽  
Entry Point ◽  
Target Point ◽  
Epileptogenic Zone ◽  
Localization Error ◽  
Drug Resistant ◽  
Robot Assisted ◽  
Data Set ◽  
Essential Information

Abstract BACKGROUND: Stereoelectroencephalography (SEEG) methodology, originally developed by Talairach and Bancaud, is progressively gaining popularity for the presurgical invasive evaluation of drug-resistant epilepsies. OBJECTIVE: To describe recent SEEG methodological implementations carried out in our center, to evaluate safety, and to analyze in vivo application accuracy in a consecutive series of 500 procedures with a total of 6496 implanted electrodes. METHODS: Four hundred nineteen procedures were performed with the traditional 2-step surgical workflow, which was modified for the subsequent 81 procedures. The new workflow entailed acquisition of brain 3-dimensional angiography and magnetic resonance imaging in frameless and markerless conditions, advanced multimodal planning, and robot-assisted implantation. Quantitative analysis for in vivo entry point and target point localization error was performed on a sub-data set of 118 procedures (1567 electrodes). RESULTS: The methodology allowed successful implantation in all cases. Major complication rate was 12 of 500 (2.4%), including 1 death for indirect morbidity. Median entry point localization error was 1.43 mm (interquartile range, 0.91-2.21 mm) with the traditional workflow and 0.78 mm (interquartile range, 0.49-1.08 mm) with the new one (P &lt; 2.2 × 10−16). Median target point localization errors were 2.69 mm (interquartile range, 1.89-3.67 mm) and 1.77 mm (interquartile range, 1.25-2.51 mm; P &lt; 2.2 × 10−16), respectively. CONCLUSION: SEEG is a safe and accurate procedure for the invasive assessment of the epileptogenic zone. Traditional Talairach methodology, implemented by multimodal planning and robot-assisted surgery, allows direct electrical recording from superficial and deep-seated brain structures, providing essential information in the most complex cases of drug-resistant epilepsy.

Abstract TP203: Factors Associated With Temporal Window Failure in Transcranial Doppler Sonography

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Chan-Hyuk Lee ◽  
Seung-Ho Jeon ◽  
Su-Jung Wang ◽  
Byoung-Soo Shin ◽  
Hyun Goo Kang
Keyword(s):  
Soft Tissue ◽  
Temporal Bone ◽  
Doppler Sonography ◽  
Transcranial Doppler Sonography ◽  
Bone Thickness ◽  
Tissue Thickness ◽  
Temporal Window ◽  
Temporal Area ◽  
Factors Affecting ◽  
Soft Tissue Thickness

Background and purpose: Temporal window failure (TWF) is found in 8-20% of subjects. Although it has been reported that, it is more common for the elderly and females, there are not enough studies on this topic. This study aimed to identify new factors affecting TWF. Methods: This study analyzed 376 patients who underwent both transcranial Doppler sonography (TCD) and cerebral angiographic imaging among patients visited the neurology department of Chonbuk National University Hospital from January to December 2018. They were divided into two groups depending on the presence of TWF. Afterward, demographics and cardiovascular factors, degree of stenosis from proximal intracranial artery (ICA) to the middle cerebral artery (MCA), and MCA diameter and skull features were examined. Results: The mean age of the patients was 68.4±12.1 years old and 241 of them (64.1%) were male. The study subjects were composed of 314 TWF negative patients (83.5%) and 62 TWF positive patients (16.5%). The stenosis from the proximal ICA to the 2/3 segment of the MCA proximal was not different between the two groups. Factors affecting TWF were analyzed using multivariate logistic regression analysis and the results showed that age (odds ratio [OR], 1.05; p =0.019), female (OR, 4.64; p =0.002), temporal bone thickness (OR, 6.03; p <0.001), temporal bone density (OR, 0.996; p =0.002), and soft tissue thickness (OR, 1.31; p =0.004) significantly affected TWF. Conclusions: We confirmed that the soft tissue thickness of the temporal area was a new associated factor of TWF in addition to the previously reported age, sex, temporal bone thickness, and temporal bone density. The results implied that measuring the soft tissue thickness of the temporal area for patients with suspected TWF would be useful to clinically identify the measurement error due to a technical problem.

A dense approach for computation of facial soft tissue thickness data

2021 ◽  
pp. 200460
Author(s):  
Diana Toneva ◽  
Silviya Nikolova ◽  
Stanislav Harizanov ◽  
Dora Zlatareva ◽  
Vassil Hadjidekov
Keyword(s):  
Soft Tissue ◽  
Tissue Thickness ◽  
Facial Soft Tissue ◽  
Soft Tissue Thickness

scholarly journals Improvement of biohistological response of facial implant materials by tantalum surface treatment

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Mohammed Mousa Bakri ◽  
Sung Ho Lee ◽  
Jong Ho Lee
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
Surface Treatment ◽  
Clinical Applications ◽  
Tissue Response ◽  
Bone Surface ◽  
Tissue Thickness ◽  
Implant Materials ◽  
Soft Tissue Thickness

Abstract Background A compact passive oxide layer can grow on tantalum (Ta). It has been reported that this oxide layer can facilitate bone ingrowth in vivo though the development of bone-like apatite, which promotes hard and soft tissue adhesion. Thus, Ta surface treatment on facial implant materials may improve the tissue response, which could result in less fibrotic encapsulation and make the implant more stable on the bone surface. The purposes of this study were to verify whether surface treatment of facial implant materials using Ta can improve the biohistobiological response and to determine the possibility of potential clinical applications. Methods Two different and commonly used implant materials, silicone and expanded polytetrafluoroethylene (ePTFE), were treated via Ta ion implantation using a Ta sputtering gun. Ta-treated samples were compared with untreated samples using in vitro and in vivo evaluations. Osteoblast (MG-63) and fibroblast (NIH3T3) cell viability with the Ta-treated implant material was assessed, and the tissue response was observed by placing the implants over the rat calvarium (n = 48) for two different lengths of time. Foreign body and inflammatory reactions were observed, and soft tissue thickness between the calvarium and the implant as well as the bone response was measured. Results The treatment of facial implant materials using Ta showed a tendency toward increased fibroblast and osteoblast viability, although this result was not statistically significant. During the in vivo study, both Ta-treated and untreated implants showed similar foreign body reactions. However, the Ta-treated implant materials (silicone and ePTFE) showed a tendency toward better histological features: lower soft tissue thickness between the implant and the underlying calvarium as well as an increase in new bone activity. Conclusion Ta surface treatment using ion implantation on silicone and ePTFE facial implant materials showed the possibility of reducing soft tissue intervention between the calvarium and the implant to make the implant more stable on the bone surface. Although no statistically significant improvement was observed, Ta treatment revealed a tendency toward an improved biohistological response of silicone and ePTFE facial implants. Conclusively, tantalum treatment is beneficial and has the potential for clinical applications.

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