Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, SE, Brazil.
Unimed Sergipe Hospital, Aracaju, SE, Brazil.
Sci Rep. 2021 Mar 24;11(1):6778. doi: 10.1038/s41598-021-85472-3.
The precise location in the scalp of specifically planned points can help to achieve less invasive approaches. This study aims to develop a smartphone app, evaluate the precision and accuracy of the developed tool, and describe a series of cases using the referred technique. The application was developed with the React Native framework for Android and iOS. A phantom was printed based on the patient's CT scan, which was used for the calculation of accuracy and precision of the method. The points of interest were marked with an "x" on the patient's head, with the aid of the app and a compass attached to a skin marker pen. Then, two experienced neurosurgeons checked the plausibility of the demarcations based on the anatomical references. Both evaluators marked the frontal, temporal and parietal targets with a difference of less than 5 mm from the corresponding intended point, in all cases. The overall average accuracy observed was 1.6 ± 1.0 mm. The app was used in the surgical planning of trepanations for ventriculoperitoneal (VP) shunts and for drainage of abscesses, and in the definition of craniotomies for meningiomas, gliomas, brain metastases, intracranial hematomas, cavernomas, and arteriovenous malformation. The sample consisted of 88 volunteers who exhibited the following pathologies: 41 (46.6%) had brain tumors, 17 (19.3%) had traumatic brain injuries, 16 (18.2%) had spontaneous intracerebral hemorrhages, 2 (2.3%) had cavernomas, 1 (1.1%) had arteriovenous malformation (AVM), 4 (4.5%) had brain abscesses, and 7 (7.9%) had a VP shunt placement. In cases approached by craniotomy, with the exception of AVM, straight incisions and minicraniotomy were performed. Surgical planning with the aid of the NeuroKeypoint app is feasible and reliable. It has enabled neurological surgeries by craniotomy and trepanation in an accurate, precise, and less invasive manner.
头皮上特定规划点的精确位置有助于实现微创方法。本研究旨在开发一款智能手机应用程序，评估所开发工具的精度和准确性，并描述使用该技术的一系列病例。该应用程序是使用 React Native 框架为 Android 和 iOS 开发的。根据患者的 CT 扫描打印出一个模型，用于计算该方法的准确性和精度。应用程序和连接到皮肤标记笔的指南针的帮助下，在患者头部标记出感兴趣的点。然后，两名经验丰富的神经外科医生根据解剖参考检查标记的合理性。在所有情况下，两名评估者都以小于 5 毫米的差异标记了额、颞和顶目标。观察到的总体平均准确性为 1.6 ± 1.0 毫米。该应用程序用于脑室-腹腔 (VP) 分流术和脓肿引流术的颅骨钻孔术的手术规划，以及脑膜瘤、神经胶质瘤、脑转移瘤、颅内血肿、海绵状血管瘤和动静脉畸形的开颅手术的定义。样本由 88 名志愿者组成，他们患有以下疾病：41 名（46.6%）患有脑肿瘤，17 名（19.3%）患有创伤性脑损伤，16 名（18.2%）患有自发性脑出血，2 名（2.3%）患有海绵状血管瘤，1 名（1.1%）患有动静脉畸形（AVM），4 名（4.5%）患有脑脓肿，7 名（7.9%）放置了 VP 分流术。在通过开颅术治疗的病例中，除 AVM 外，均进行直切口和微型开颅术。借助 NeuroKeypoint 应用程序进行手术规划是可行且可靠的。它以准确、精确和微创的方式实现了神经外科手术的开颅术和颅骨钻孔术。
