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Insights from using biplanar intersection for freehand frontal ventriculostomy: a retrospective case-control study
Kailong Huang1,2, Xu Zhan1, Tinghui Xue1
1Department of Neurosurgery, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China.
Quantitative Imaging in Medicine and Surgery
|February 25, 2025
Summary
The novel biplanar intersection (BI) method improves frontal ventriculostomy accuracy in neurosurgery. This technique offers enhanced precision and reduced deviation compared to traditional methods.
Area of Science:
- Neurosurgery
- Medical Imaging
- Surgical Navigation
Background:
- Frontal ventriculostomy (FV) is a critical neurosurgical procedure.
- Traditional freehand puncture methods lack accuracy.
- Ultrasound guidance for FV is time-consuming and costly.
Purpose of the Study:
- To introduce and analyze the biplanar intersection (BI) method for frontal horn puncture.
- To enhance the accuracy of freehand frontal ventriculostomy.
- To investigate the frontal horn puncture mechanism using the BI method.
Main Methods:
- Utilized 3D CT reconstruction from 135 patients (aged ≥18) with enlarged lateral ventricles (Evans index >0.33).
- Applied BI principles to determine puncture coordinates and performed variance analysis.
- Simulated BI method punctures and compared outcomes with traditional techniques, using statistical analysis (chi-squared and t-tests).
Main Results:
- The BI method demonstrated a significantly higher optimal puncture rate (100% vs. 86.1%, P=0.021).
- BI method resulted in substantially reduced lateral deviation (2.69 mm vs. 13.97 mm, P<0.05).
- Established specific anatomical entry points for lateral and anterior projections relative to facial landmarks.
Conclusions:
- The BI method, based on mathematical principles, shows enhanced precision for ventriculostomy.
- Simulations indicate improved puncture efficiency with the BI technique.
- Further clinical research is recommended to validate the effectiveness of the BI method.
