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Long-term assessment of intracranial pressure using the tympanic membrane displacement measurement technique
S M Moss1, R J Marchbanks, D M Burge
1Institute of Sound and Vibration Research, University of Southampton, U.K.
Insights
Tympanic intracranial pressure (ICP) measurement effectively monitors shunted hydrocephalic children. This technique aids in diagnosing acute and chronic shunt malfunction, improving long-term patient management.
Area of Science:
- Pediatric Neurosurgery
- Medical Device Technology
- Intracranial Pressure Monitoring
Background:
- Hydrocephalus is a condition requiring shunting in children.
- Shunt malfunction is a common complication, necessitating reliable monitoring.
- Accurate intracranial pressure (ICP) assessment is crucial for managing shunted patients.
Observation:
- Tympanic ICP measurement was applied to two pediatric patient groups over several months.
- In shunted hydrocephalic children, tympanic ICP monitoring showed correlation with clinical and operative findings, particularly in cases of suspected shunt blockage.
- Serial tympanic ICP testing in children with chronic symptoms suggestive of elevated ICP demonstrated a link between symptoms and actual ICP levels.
Findings:
- The tympanic ICP measurement technique proved valuable in assessing both acute and chronic shunt malfunctions in children.
- A significant correlation was observed between tympanic ICP readings and clinical outcomes, including the identification of shunt blockages.
- Repeated tympanic ICP measurements in children with chronic symptoms helped correlate symptoms with ICP fluctuations and guided management decisions.
Implications:
- Tympanic ICP measurement offers a non-invasive, valuable tool for the long-term management of shunted hydrocephalic children.
- Serial ICP monitoring via the tympanic route can serve as a key diagnostic indicator for pressure variations and shunt dysfunction.
- This method has the potential to improve clinical decision-making and patient outcomes in pediatric neurosurgery.
Abstract:
The tympanic intracranial pressure (ICP) measurement technique was used to assess intracranial pressure over several months in two patient populations. In the first study, 43 shunted hydrocephalic children, aged 4-17 years, were tested over a period of 18 months when clinically well. Of these 11 (26%) were later admitted with symptoms suggesting acute shunt blockage. The tympanic ICP measurement correlated with clinical and/or operative findings in 10 cases. In the second study, illustrated by a case report, repeated testing over a period of 5 months in children with chronic symptoms suggestive of periods of increased ICP, demonstrated a correlation between symptoms and ICP and helped influence management decisions. Tympanic ICP measurement in shunted children is a valuable tool in the assessment of acute and chronic shunt malfunction. Serial testing was shown to be clinically useful in the long-term management of these patients as a diagnostic indicator of pressure variation and shunt dysfunction.