Ventrikülostomide anatomi temelli navigasyon: Nazion-Koronal sütür arası mesafe ölçümü

Öz

Amaç: Bu çalışmada nazion sınır olarak kullanılarak koronal sütür lokalizasyonu tespit edilmeye çalışılmıştır. Nazion-koronal sütür arası mesafe bildiğimiz kadarı ile Türk toplumunda ilk defa bu çalışma ile literatüre sunulmaktadır. Yöntemler: Bu çalışmada 30 kranium ve 30 frontal kemik kullanılmıştır. Her bir kafatasında mezuro yardımı ile nazal sütürden koronal sütüre olan mesafe ölçülmüştür. Sonuçlar: Nazal sütür-koronal sütür arası mesafe 12,2 cm (minimum 10,3-maksimum 13,5 cm) olarak tespit edildi. Tartışma: Nazion cilt üzerinden kolayca palpe edilebilen bir işaret noktasıdır. Naziondan 12 cm posteriorda orta hattan 3 cm lateralde yapılacak küçük bir cilt insizyonu ile drenaj noktası kolayca tespit edilebilir. Bu bilgi beyin cerrahları için her zaman kullanabilecekleri pratik bir bilgi olarak literatüre sunulmaktadır.

Anahtar Kelimeler

• Koronal sütür, eksternal ventriküler drenaj, hidrosefali, subaraknoid kanama, şant enfeksiyonu

Anatomy-Based navigation for ventriculostomy: Nasion-coronal suture distance measurement

Abstract

Objective: In this study we aimed to determine a landmark that can be measured through the skin with nasal mid-point (bregma) to coronal suture, and additionally an average value was calculated. We report, to our knowledge, the distance between the nasion-coronal sutures is reported for the first time in Turkish population. Methods: The study included 30 craniums and 30 frontal bones. Each skull from midline nasal suture to coronal suture curved up at the distance was measured with tape measure. Results: Mean values were determined. Nasal suture between coronal suture distance average 12,2 cm (min10,3 cm, up to 13,5 cm) were detected. Conclusion: Nasal suture is an easily palpable area through the skin. A small incision is carried down through skin to bone at the spot 12 cm back from the nasion 3 cm lateral to the midline for ventricular drainage operation. This data provide practical information for neurosurgeon and is available everywhere. J Clin Exp Invest 2014; 5 (3): 368-370

Keywords

• Coronal suture, external ventricular drainage, hydrocephalus, subarachnoid hemorrhage, shunt infection

Kaynakça

1. Rajz G, Shooman D, Goren O, et al. Non-invasive re- positioning of the ventricular catheter after suboptimal ventriculoperitoneal shunt placement. Acta Neurochir 2010;152:1435-1436.
2. Azeem SS, Origitano TC. Ventricular catheter place- ment with a frameless neuronavigational system: A 1-year experience. Neurosurg 2007;60:243-248.
3. Bauer DF, Tubbs RS, Satchivi LA. The Seldinger tech- nique for ventricular catheter exchange: A technical note. Childs Nerv Syst 2008;24:753-755.
4. Daszkiewicz P, Barszcz S. Multiple shunt system revi- sions in patients with hydrocephalus - causes, effects, regularities and prognostic factors. Neurol Neurochir Pol. 2007;41:404-410.
5. Chrcanovic BR, Abreu MH, Custódio AL. A morpho- metric analysis of supraorbital and infraorbital foram- ina relative to surgical landmarks. Surg Radiol Anat 2011;33:329-335.
6. Cotton F, Rozzi FR, Vallee B, et al. Cranial sutures and craniometric points detected on MRI. Surg Radiol Anat 2005;27:64-70.
7. Dunn IF, Frerichs K, Day AL. Perioperative manage- ment of severe traumatic brain injuri in adults. In Schmidek HH, Roberts DW (eds), Operative Neuro- surgical Techniques 5th edn. Philadelphia: Elsevier, 2006:31-44.
8. Ebeling U, Rikli D, Huber P, et al. The coronal suture, a useful bony landmark in neurosurgery? Craniocere- bral topography between bony landmarks on the skull and the brain. Acta Neurochir 1987;89:130-134.

9. Hattapoğlu S, Hamidi C, Göya C, et al. Congenital bilat- eral perisylvian syndrome with hydrocephalus. J Clin Exp Invest 2012;3:552-554.
10. Annagür A, Altunhan H, Ertuğrul S, et al. A rare cause of neonatal meningitis: Group A streptococci. Dicle Med J 2013; 40:118-120.
11. Abuhandan M, Çalık M, Oymak Y, et al. Meningitis in children: Analysis of 92 cases. Dicle Med J 2013; 40:15-20.
12. Dickinson BP, Spoon DB, Cordray TL, et al. Correc- tion of massive hydrocephalus and brain wound in holoprosencephaly. Craniofac Sur 2006;17:707-713.
13. Bafeltowska JJ, Buszman E, Mandat KM, et al. Thera- peutic vancomycin monitoring in children with hydro- cephalus during treatment of shunt infections. Surg Neurol 2004;62:142-150.
14. Lee CK, Tay LL, Ng WH, et al. Optimization of ven- tricular catheter placement via posterior approach- es: A virtual reality simulation study. Surg Neurol 2008;70:274-277.
15. Oguz O, Sanli SG, Bozkir MG, et al. The pterion in Turkish male skulls. Surg Radiol Anat 2004;26:220- 224.
16. Pirotte B, James S, Lubansu A, et al. Sterile surgi- cal technique for shunt placement reduces the shunt infection rate in children: preliminary analysis of a prospective protocol in 115 consecutive procedures. Childs Nerv Syst 2007;23:1251-1261.
17. Simon TD, Mayer-Hamblett N, Whitlock KB, et al. Few Patient, Treatment, and Diagnostic or Microbiological Factors, Except Complications and Intermittent Nega- tive Cerebrospinal Fluid (CSF) Cultures During First CSF Shunt Infection, Are Associated With Reinfec- tion. J Pediatric Infect Dis Soc 2014;3:15-22.
18. Sun P, Shin JH, Persing JA. Management of the ven- tricular shunt in posterior deformities of the skull in craniosynostosis. J Craniofac Surg 1997;8:38-41.
19. Thomale UW, Hosch H, Koch A, et al. Perforation holes in ventricular catheters-is less more? Childs Nerv Syst 2010;26:781-789.
20. Tuli S, Hayon BO, Drake J, et al. Change in ventricu- lar size and effect of ventricular catheter placement in pediatric patients with shunted hydrocephalus. Neuro- surg 1999;45:1329-1333.
21. Villavicencio AT, Leveque JC, McGirt MJ, et al. Com- parison of revision rates following endoscopically ver- sus nonendoscopically placed ventricular shunt cath- eters. Surg Neurol 2003;59:375-379.