Related Experiment Video
Updated: Mar 27, 2026
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
The Neurosurgical Stethoscope-Advancing Bedside Imaging in Neurosurgery Through Sonolucent Cranial Implants: A Case
Omer Doron1, Marcio Yuri Ferreira2, Shayan Huda2
1Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Background And Objectives:
Postoperative imaging evaluation through ultrasound (US) in neurosurgical patients has been limited by the poor penetration of US waves through the intact skull. Translucent cranial implants (TCI) circumvent this limitation by creating an acoustic window through which US can be effectively transmitted, allowing for practical bedside transcranioplasty US (TCUS). We hypothesize that TCUS can provide a rapid, noninvasive postoperative diagnostic and screening tool, functioning as a potential "neurosurgical stethoscope" to guide immediate reliable diagnostic tool, and reduce reliance on frequent computed tomography (CT) or MRI scanning. In this study, we aimed to assess the feasibility and applicability of bedside TCUS as a bedside diagnostic tool.
Methods:
This is a retrospective case-series. Patients included were: (1) 18 years or more; (2) underwent a cranioplasty with a TCI after craniectomy or burr-hole craniectomy for brain-pathologies; (3) after cranioplasty with a TCI, the patient postoperative or long-term follow-up surveillance prompted for CT or MRI; (4) underwent a bedside TCUS before CT or MRI; and (5) immediately after bedside TCUS the patient underwent CT or MRI-imaging.
Results:
Nine patients (age range 40-76) were included. All patients received TCI ranging from burr-hole covers to hemicraniectomy cranioplasties (2-16 cm). The TCUS assessment range time was 2-5 minutes. Cases included immediately postoperative surveillance, on patient deterioration prompting imaging evaluation, inpatient serial monitorization, predischarge evaluation and outpatient long-term follow-up evaluation. In all cases, TCUS and CT or MRI qualitative findings/reports were in agreement.
Conclusion:
This initial investigation demonstrates our preliminary results on the feasibility and applicability of TCUS as a diagnostic tool for the postoperative surveillance and long-term follow-up of patients who underwent cranioplasty with sonolucent cranial implants. As an initial investigation, with limited generalization, our findings indicate promising feasibility and applicability of TCUS as a "neurosurgical stethoscope" and provide a foundation and insights for further investigation.
