Brain ultrasound rehearsal before surgery: A pilot cadaver study

Abstract

It has been shown that brain ultrasonography (US) is an efficient tool for improving three-dimensional (3D) spatial orientation during neurosurgical interventions. However, it necessitates specific training as it is highly operator-dependent. To date, neurosurgeons have relied solely on intraoperative practice to improve their mastery of brain US; this has obvious limitations. Herein, we consider whether a study of brain US on human cadavers could enable a training platform for neurosurgeons and residents to be developed. Standard two-dimensional (2D) brain US was performed on two human cadavers (one fresh-frozen and one Thiel-prepared) through left frontoparietal, left frontal, right temporal, and left parietal craniotomies. US workflow and image quality were assessed in both preparations. It was possible to assess US in both cadaver preparations; however, the specimen prepared with Thiel-fixation performed better, with superior image quality and specimen usability at room temperature. US images were obtainable through all surgical corridors with the main intracranial anatomical landmarks easily identifiable. US of cadaveric brains is feasible and delivers good quality results. This technique could allow neurosurgeons to develop the expertise required for a successful clinical application preoperatively. Clin. Anat. 30:1017-1023, 2017. © 2017 Wiley Periodicals, Inc.

Current and potential use of fresh frozen cadaver in surgical training and anatomical education

“…Three studies (Bell et al, 2020; Fernandez‐Gibello et al, 2019; Giussani et al, 2017) reported the use of FFC in ultrasound‐related training. One article reported a pilot study on performing ultrasonography on the brain for neurosurgeons using FFCs.…”

“…The researchers performed 2D ultrasonography on 1 FFC and 1 Thiel‐fixed cadaver. The results showed that both cadaveric models were feasible in obtaining sufficient quality for valid assessment (Giussani et al, 2017). However, due to the frozen status of FFC, Thiel‐fixed cadavers showed superior image quality.…”

“…However, due to the frozen status of FFC, Thiel‐fixed cadavers showed superior image quality. Nevertheless, FFC provided images clear enough to assess all sides of the human brain (Giussani et al, 2017). This study highlighted the potential drawbacks and areas for development of FFCs.…”

Application and Feasibility of Bedside Cranial Ultrasound in Patients with a Translucent Cranial Implant: A Potential Path for an Introduction of a “Neurosurgical Stethoscope”

“…As an imaging modality, ultrasound has been historically underused in neurosurgery [ (Harary et al 2018)]. As a result, it is not a tool routinely used during training and most aren't comfortable interpreting or performing brain US scans as compared with MRI and CT [ (Giussani et al 2017;Müns et al 2014)]. While bedside ultrasound was useful in the above series to rapidly and reliably rule out major post-operative complications, the potential introduction of ultrasound as a viable and readily available option in neurosurgical patients in the acute post-operative state is dependent on use of a sonolucent implant.…”