A Stencil Instrument for Countersinking Deep Brain Stimulator Lead Anchoring Devices

Miller, Kai J.

doi:10.1016/j.wneu.2022.08.058

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…To minimize this risk, countersinking the burr hole device has been reported, with some authors describing their experience with the development of stencils to facilitate this. 5,6,10 In the event that skin erosion does occur, detailed treatments often involve local debridement and fibrotic capsule release, transpositional or rotation soft tissue flaps, skin grafts with negative pressure wound devices applied on the donor site, and free tissue transfer when poorquality adjacent scalp does not allow viable flap transposition. 9,[11][12][13] We present this technique of recessing, or countersinking, the shunt system into the skull as another tool in the armamentarium for shunt revision considerations.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Other techniques, including recessing, or countersinking, the implant into the surrounding skull have been described in functional neurosurgery to reduce internal stress on the wound overlying an implanted device. 5,6 Here, we present a complex case of a pediatric patient with Pfeiffer syndrome and shunted hydrocephalus who had presented with shunt erosion through the skin in the setting of multiple prior shunt revisions and cranial vault remodeling surgeries and was treated with external ventricular drainage, empirical antibiotics, and reinternalization, with the shunt recessed into the calvarial bone to decrease pressure on friable scalp skin. We highlight this case to review the technique and the literature behind wound healing optimization in pediatric shunt surgery.…”

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confidence: 99%

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Approaches to ventriculoperitoneal shunt scalp erosion: countersinking into the calvarium. Illustrative case

Brunozzi,

LoPresti,

McGrath

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Ventriculoperitoneal shunting (VPS) is a standard procedure for the treatment of hydrocephalus, and the management of its complications is common in the practice of pediatric neurosurgery. Shunt exposure, though a rare complication, can occur because of thin, fragile skin, a young patient age, protuberant hardware, poor scalp perfusion, and a multitude of other patient factors. OBSERVATIONS The authors report a complex case of VPS erosion through the scalp in a young female with Pfeiffer syndrome treated with external ventricular drainage, empirical antibiotics, and reinternalization with countersinking of replaced shunt hardware into the calvarium to prevent internal skin pressure points, reduce wound tension, and allow wound healing. LESSONS Recessing the shunt hardware, or countersinking the implant, into the calvarium is a simple technique often used in functional neurosurgical implantation surgeries, providing a safe surgical strategy to optimize wound healing in select cases in which the skin flap is unfavorable.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Approaches to ventriculoperitoneal shunt scalp erosion: countersinking into the calvarium. Illustrative case

Brunozzi,

LoPresti,

McGrath

et al. 2023

Journal of Neurosurgery: Case Lessons

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Section: Nerve Interfacementioning

confidence: 99%

“…This approach effectively reduced wound size and mitigated inflammatory glial reactions, making it applicable to deep brain stimulation therapy (Fig. 5e ) [ 62 ].…”

Section: Nerve Interfacementioning

confidence: 99%

Liquid metal biomaterials: translational medicines, challenges and perspectives

Xu,

Lu,

et al. 2023

National Science Review

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Until now, significant healthcare challenges and growing urgent clinical requirements remain incompletely addressed by presently available biomedical materials. This is due to their inadequate mechanical compatibility, suboptimal physical and chemical properties, susceptibility to immune rejection, and concerns about long-term biological safety. As an alternative, liquid metal (LM) opens up a promising class of biomaterials with unique advantages like biocompatibility, flexibility, excellent electrical conductivity, and ease of functionalization. However, despite the unique advantages and successful explorations of LM in biomedical fields, widespread clinical translations and applications of LM-based medical products remain limited. This article summarizes the current status and future prospects of LM biomaterials, interprets their applications in healthcare, medical imaging, bone repair, nerve interface, and tumor therapy, etc. Opportunities to translate LM materials into medicine and obstacles encountered in practices are discussed. Following that, we outline a blueprint for LM clinics, emphasizing their potential in making new-generation artificial organs. Last, the core challenges of LM biomaterials in clinical translation, including bio-safety, material stability, and ethical concerns are also discussed. Overall, the current progress, translational medicine bottlenecks, and perspectives of LM biomaterials signify their immense potential to drive future medical breakthroughs and thus open up novel avenues for upcoming clinical practices.

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A General Framework for Characterizing Inaccuracy in Stereotactic Systems

Jensen,

Neimat,

Kerezoudis

et al. 2024

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Identifying and characterizing sources of targeting error in stereotactic procedures is essential to maximizing accuracy, potentially improving surgical outcomes. We aim to describe a generic framework which characterizes sources of stereotactic inaccuracy. METHODS: We assembled a list of stereotactic systems: ROSA, Neuromate, Mazor Renaissance, ExcelsiusGPS, Cirq, STarFix (FHC), Nexframe, ClearPoint, CRW, and Leksell. We searched the literature for qualitative and quantitative work identifying and quantifying potential sources of inaccuracy and describing each system's implementation using Standards for Reporting Qualitative Research guidelines. Our literature search spanned 1969 to 2024, and various studies were included, with formats ranging from phantom studies to systematic reviews. Keyword searches were conducted, and the details about each system were used to create a framework for identifying and describing the unique targeting error profile of each system. RESULTS: We describe and illustrate the details of various sources of stereotactic inaccuracies and generate a framework to unify these sources into a single framework. This framework entails 5 domains: imaging, registration, mechanical accuracy, target planning and adjustment, and trajectory planning and adjustment. This framework was applied to 10 stereotactic systems. CONCLUSION: This framework provides a rubric to analyze the sources of error for any stereotactic system. Illustrations allow the reader to understand sources of error conceptually so that they may apply them to their practice.

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A Stencil Instrument for Countersinking Deep Brain Stimulator Lead Anchoring Devices

Cited by 3 publications

References 6 publications

Approaches to ventriculoperitoneal shunt scalp erosion: countersinking into the calvarium. Illustrative case

Approaches to ventriculoperitoneal shunt scalp erosion: countersinking into the calvarium. Illustrative case

Liquid metal biomaterials: translational medicines, challenges and perspectives

A General Framework for Characterizing Inaccuracy in Stereotactic Systems

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