Marker-CT assisted surgery using household key ring: A simple substitute to frameless stereotaxy for developing countries
Operative localization systems such as stereotactic frames and neuronavigation are prohibitively expensive to be of use in many centers in developing countries. Here, we present a modified version of marker-computed tomography (CT) assisted technique using a household key ring, which can be performe...
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Veröffentlicht in: | Surgical neurology international 2014, Vol.5 (1), p.109 |
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description | Operative localization systems such as stereotactic frames and neuronavigation are prohibitively expensive to be of use in many centers in developing countries. Here, we present a modified version of marker-computed tomography (CT) assisted technique using a household key ring, which can be performed in any operative set-up lacking modern amenities.
For a patient who presents with left posterior frontal lesion, the approximate entry point for the shortest and perpendicular trajectory to the lesion is marked on the scalp using a household key ring and fixed in place. Helical CT is obtained and reconstruction performed in two planes perpendicular to the ring and mutually perpendicular to each other. Based on the measurements of the lesion in relation to the radiologic pointers of the ring, and the location of the corrected entry point with respect to the center of the ring, the shortest perpendicular depth of approach is determined. Freehand technique perpendicular to the surface at the predetermined entry point and depth is employed for the surgical approach. The advantages of key ring over other markers are its simplicity, conformity to the shape of the head, and paucity of artifacts in CT.
The relatively effortless estimation and three-dimensional visual impression renders this method easy enough to be employed anywhere for the operative localization of superficial intracranial lesions both for biopsy as well as resection. |
doi_str_mv | 10.4103/2152-7806.137195 |
format | Article |
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For a patient who presents with left posterior frontal lesion, the approximate entry point for the shortest and perpendicular trajectory to the lesion is marked on the scalp using a household key ring and fixed in place. Helical CT is obtained and reconstruction performed in two planes perpendicular to the ring and mutually perpendicular to each other. Based on the measurements of the lesion in relation to the radiologic pointers of the ring, and the location of the corrected entry point with respect to the center of the ring, the shortest perpendicular depth of approach is determined. Freehand technique perpendicular to the surface at the predetermined entry point and depth is employed for the surgical approach. The advantages of key ring over other markers are its simplicity, conformity to the shape of the head, and paucity of artifacts in CT.
The relatively effortless estimation and three-dimensional visual impression renders this method easy enough to be employed anywhere for the operative localization of superficial intracranial lesions both for biopsy as well as resection.</description><identifier>ISSN: 2229-5097</identifier><identifier>ISSN: 2152-7806</identifier><identifier>EISSN: 2152-7806</identifier><identifier>DOI: 10.4103/2152-7806.137195</identifier><identifier>PMID: 25101204</identifier><language>eng</language><publisher>India: Scientific Scholar</publisher><subject>Accuracy ; Biopsy ; Case Report ; Developing countries ; LDCs ; Neurosurgery ; NMR ; Nuclear magnetic resonance</subject><ispartof>Surgical neurology international, 2014, Vol.5 (1), p.109</ispartof><rights>Copyright Medknow Publications & Media Pvt Ltd 2014</rights><rights>Copyright: © 2013 Dhandapani S 2014</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4123268/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4123268/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4022,27922,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25101204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dhandapani, Sivashanmugam</creatorcontrib><creatorcontrib>Singh, Harnarayan</creatorcontrib><title>Marker-CT assisted surgery using household key ring: A simple substitute to frameless stereotaxy for developing countries</title><title>Surgical neurology international</title><addtitle>Surg Neurol Int</addtitle><description>Operative localization systems such as stereotactic frames and neuronavigation are prohibitively expensive to be of use in many centers in developing countries. Here, we present a modified version of marker-computed tomography (CT) assisted technique using a household key ring, which can be performed in any operative set-up lacking modern amenities.
For a patient who presents with left posterior frontal lesion, the approximate entry point for the shortest and perpendicular trajectory to the lesion is marked on the scalp using a household key ring and fixed in place. Helical CT is obtained and reconstruction performed in two planes perpendicular to the ring and mutually perpendicular to each other. Based on the measurements of the lesion in relation to the radiologic pointers of the ring, and the location of the corrected entry point with respect to the center of the ring, the shortest perpendicular depth of approach is determined. Freehand technique perpendicular to the surface at the predetermined entry point and depth is employed for the surgical approach. The advantages of key ring over other markers are its simplicity, conformity to the shape of the head, and paucity of artifacts in CT.
The relatively effortless estimation and three-dimensional visual impression renders this method easy enough to be employed anywhere for the operative localization of superficial intracranial lesions both for biopsy as well as resection.</description><subject>Accuracy</subject><subject>Biopsy</subject><subject>Case Report</subject><subject>Developing countries</subject><subject>LDCs</subject><subject>Neurosurgery</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><issn>2229-5097</issn><issn>2152-7806</issn><issn>2152-7806</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpVkUFP3DAQha2qFSDYOydkqeeAx46TmAMSWrWlEhWX7dlynMluILtePAki_76Olq5aX2yN33xvRo-xSxDXOQh1I0HLrKxEcQ2qBKM_sbNj6XN6S2kyLUx5yhZEzyIdpQCEOWGnUoMAKfIzNv1y8QVjtlxxR9TRgA2nMa4xTnykbrfmmzASbkLf8BeceEylW37Pqdvue0zSmoZuGAfkQ-BtdFvskYgnTsQwuPeJtyHyBt-wD_sZ58O4G2KHdMG-tK4nXHzc5-z392-r5UP2-PTj5_L-MfNSG505XZctKAOFlzKHsgBT1wIqRC8KqXWt0-7eNw0klct9VZXGlx6NamqjCqHO2d2Bux_rLTYek73r7T52WxcnG1xn___ZdRu7Dm82B6lkUSXA1w9ADK8j0mCfwxh3aWYLuhBSVFLONuKg8jEQRWyPDiDsnJedw7FzOPaQV2q5-neyY8PfdNQfBkCSfQ</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Dhandapani, Sivashanmugam</creator><creator>Singh, Harnarayan</creator><general>Scientific Scholar</general><general>Medknow Publications & Media Pvt Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope></search><sort><creationdate>2014</creationdate><title>Marker-CT assisted surgery using household key ring: A simple substitute to frameless stereotaxy for developing countries</title><author>Dhandapani, Sivashanmugam ; Singh, Harnarayan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2595-a5b7f13916c22417619bb018eec06255b5719ccdd1f13a4c8879c7ce93db93603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Accuracy</topic><topic>Biopsy</topic><topic>Case Report</topic><topic>Developing countries</topic><topic>LDCs</topic><topic>Neurosurgery</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><toplevel>online_resources</toplevel><creatorcontrib>Dhandapani, Sivashanmugam</creatorcontrib><creatorcontrib>Singh, Harnarayan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical neurology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dhandapani, Sivashanmugam</au><au>Singh, Harnarayan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Marker-CT assisted surgery using household key ring: A simple substitute to frameless stereotaxy for developing countries</atitle><jtitle>Surgical neurology international</jtitle><addtitle>Surg Neurol Int</addtitle><date>2014</date><risdate>2014</risdate><volume>5</volume><issue>1</issue><spage>109</spage><pages>109-</pages><issn>2229-5097</issn><issn>2152-7806</issn><eissn>2152-7806</eissn><abstract>Operative localization systems such as stereotactic frames and neuronavigation are prohibitively expensive to be of use in many centers in developing countries. Here, we present a modified version of marker-computed tomography (CT) assisted technique using a household key ring, which can be performed in any operative set-up lacking modern amenities.
For a patient who presents with left posterior frontal lesion, the approximate entry point for the shortest and perpendicular trajectory to the lesion is marked on the scalp using a household key ring and fixed in place. Helical CT is obtained and reconstruction performed in two planes perpendicular to the ring and mutually perpendicular to each other. Based on the measurements of the lesion in relation to the radiologic pointers of the ring, and the location of the corrected entry point with respect to the center of the ring, the shortest perpendicular depth of approach is determined. Freehand technique perpendicular to the surface at the predetermined entry point and depth is employed for the surgical approach. The advantages of key ring over other markers are its simplicity, conformity to the shape of the head, and paucity of artifacts in CT.
The relatively effortless estimation and three-dimensional visual impression renders this method easy enough to be employed anywhere for the operative localization of superficial intracranial lesions both for biopsy as well as resection.</abstract><cop>India</cop><pub>Scientific Scholar</pub><pmid>25101204</pmid><doi>10.4103/2152-7806.137195</doi><oa>free_for_read</oa></addata></record> |
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source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
subjects | Accuracy Biopsy Case Report Developing countries LDCs Neurosurgery NMR Nuclear magnetic resonance |
title | Marker-CT assisted surgery using household key ring: A simple substitute to frameless stereotaxy for developing countries |
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