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- Hansen Bow, Xiaochen Yang, Silky Chotai, Michael Feldman, Hong Yu, Dario J Englot, Michael I Miga, Sumit Pruthi, Benoit M Dawant, and Scott L Parker.
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: hansen.c.bow@vumc.org.
- World Neurosurg. 2020 May 1; 137: 350-356.
BackgroundChronic subdural hematoma evacuation can be achieved in select patients through bedside placement of the Subdural Evacuation Port System (SEPS; Medtronic, Inc., Dublin, Ireland). This procedure involves drilling a burr hole at the thickest part of the hematoma. Identifying this location is often difficult, given the variable tilt of available imaging and distant anatomic landmarks. This paper evaluates the feasibility and accuracy of a bedside navigation system that relies on visible light-based 3-dimensional (3D) scanning and image registration to a pre-procedure computed tomography scan. The information provided by this system may increase accuracy of the burr hole location.MethodsIn Part 1, the accuracy of this system was evaluated using a rigid 3D printed phantom head with implanted fiducials. In Part 2, the navigation system was tested on 3 patients who underwent SEPS placement.ResultsThe error in registration of this system was less than 2.5 mm when tested on a rigid 3D printed phantom head. Fiducials located in the posterior aspect of the head were difficult to reliably capture. For the 3 patients who underwent 5 SEPS placements, the distance between anticipated SEPS burr hole location based on registration and actual burr hole location was less than 1cm.ConclusionsA bedside cranial navigation system based on 3D scanning and image registration has been introduced. Such a system may increase the success rate of bedside procedures, such as SEPS placement. However, technical challenges such as the ability to scan hair and practical challenges such as minimization of patient movement during scans must be overcome.Copyright © 2020 Elsevier Inc. All rights reserved.
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