Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan; Division of Neurosurgery, Department of Surgery, Thammasat University Hospital, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Department of Neurosurgery, Osaka Metropolitan University, Graduate School of Medicine, Osaka, Japan.
World Neurosurg. 2023 Jul;175:e1210-e1219. doi: 10.1016/j.wneu.2023.04.099. Epub 2023 Apr 30.
Electrodes for stereotactic electroencephalography (SEEG) are typically fixed to the skull with anchor bolts. When anchor bolts are unavailable, electrodes have to be fixed using other methods, carrying the possibility of electrode shift. This study, therefore, evaluated the characteristics of electrode tip shift during SEEG monitoring in patients with electrodes fixed using the suture technique.
We retrospectively included patients who underwent SEEG implantation with suture fixation and evaluated the tip shift distance (TSD) of electrodes. Possible influences evaluated included: 1) implantation period, 2) lobe of entry, 3) unilateral or bilateral implantation, 4) electrode length, 5) skull thickness, and 6) scalp thickness difference.
A total of 50 electrodes in 7 patients were evaluated. TSD was 1.4 ± 2.0 mm (mean ± standard deviation). Implantation period was 8.1 ± 2.2 days. Entry lobe was frontal for 28 electrodes and temporal for 22 electrodes. Implantation was bilateral for 25 electrodes and unilateral for 25 electrodes. Electrode length was 45.4 ± 14.3 mm. Skull thickness was 6.0 ± 3.7 mm. Scalp thickness difference was -1.5 ± 2.1 mm, which was found greater in temporal lobe entry compared with frontal lobe entry. According to univariate analyses, neither implantation period nor electrode length correlated with TSD. Multivariate regression analysis showed that only greater scalp thickness difference correlated significantly with greater TSD (P = 0.0018).
Greater scalp thickness difference correlated with greater TSD. Surgeons need to consider the degree of scalp thickness difference and electrode shift when using suture fixation, especially with temporal lobe entry.
立体定向脑电图（SEEG）电极通常通过锚定螺栓固定在颅骨上。当锚定螺栓不可用时，必须使用其他方法固定电极，这可能会导致电极移位。因此，本研究评估了使用缝线技术固定电极的患者在 SE EG 监测期间电极尖端移位的特征。
我们回顾性纳入了使用缝线固定进行 SE EG 植入的患者，并评估了电极的尖端移位距离（TSD）。评估的可能影响因素包括：1）植入期，2）进入叶，3）单侧或双侧植入，4）电极长度，5）颅骨厚度和 6）头皮厚度差异。
共评估了 7 名患者的 50 个电极。TSD 为 1.4±2.0mm（均值±标准差）。植入期为 8.1±2.2 天。进入叶为额叶 28 个电极，颞叶 22 个电极。双侧植入 25 个电极，单侧植入 25 个电极。电极长度为 45.4±14.3mm。颅骨厚度为 6.0±3.7mm。头皮厚度差异为-1.5±2.1mm，颞叶进入时比额叶进入时更大。根据单因素分析，植入期和电极长度均与 TSD 无相关性。多变量回归分析显示，只有更大的头皮厚度差异与更大的 TSD 显著相关（P=0.0018）。
更大的头皮厚度差异与更大的 TSD 相关。外科医生在使用缝线固定时需要考虑头皮厚度差异和电极移位的程度，尤其是在颞叶进入时。
