Use of navigation technologies in the installation of external ventricular drainage in patients with severe combined traumatic brain injury
- Authors: Badalov V.I.1, Tyulikov P.K.1, Mityunina V.S.2, Spitsin M.I.1, Korostelev K.E.1, Tyulikov K.V.1, Yarmoshuk R.V.1, Zhukov V.S.1, Ismailov I.K.1
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Affiliations:
- Kirov Military Medical Academy
- The S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation, St. Petersburg, Russia
- Issue: Vol 25, No 3 (2023)
- Pages: 413-421
- Section: Research paper
- Submitted: 17.05.2023
- Accepted: 18.07.2023
- Published: 05.10.2023
- URL: https://journals.eco-vector.com/1682-7392/article/view/430289
- DOI: https://doi.org/10.17816/brmma430289
- ID: 430289
Cite item
Abstract
The study investigated the possibilities and effectiveness of surgical navigation in the installation of external ventricular drainage in patients with severe combined traumatic brain injury. In total, 41 patients were examined, and in those with urgent indications during the first period of traumatic illness, external ventricular drainage was installed (up to 2 days). All patients were divided into the main group (n = 14) and control group (n = 27). In the main group, external ventricular drainage was installed using surgical navigation. The control group underwent surgery without surgical navigation. According to the treatment results of the main group, the use of surgical navigation during the introduction of ventricular drainage significantly increased the accuracy of its installation and reduced the number of complications and rechecks. The accuracy of ventricular drainage installation was improved by 35%. Thus, out of 13 drainage installations, 12 (92.3%) had an optimal position, and 1 had a satisfactory position because its tip had a deviation of 2 mm; however, this drainage did not require re-examination, performing its function. Moreover, in the control group using the classical “free hand” technique, out of 21 cases with drainage installed, only 12 (57.1%) had an optimal position, 9 (42.9%) drains were rechecked because of deviation from the specified trajectory over 3 mm, and 4 (19%) required repeated rechecking (p = 0.039). The main causes of errors and complications of the surgical treatment of patients with craniocerebral injuries are related to the difficulties in installing ventricular drainage, namely, inaccurate positioning of the drainage tip, placement of the drainage in the brain substance at a distance from the planned point (28.6%), the drainage is going beyond the ventricular system of the brain (14.3%), re-drainage during the operation (44.4%), which often (42.9%) leads to incorrect introduction of the drainage into the ventricular system of the brain. Thus, the application of the navigation technology technique when installing drains into the ventricular system of the brain is very effective in the treatment of patients with severe combined traumatic brain injury. This innovative technique for ventricular drainage in severe combined traumatic brain injury will reduce the frequency of errors and complications associated with repeated drains, which is fundamentally important in unstable patients with multiple traumas. The navigation system allows for accurate installation of the drainage to the planned location from the first attempt.
Full Text
About the authors
Vadim I. Badalov
Kirov Military Medical Academy
Email: vadim_badalov@mail.ru
ORCID iD: 0000-0002-8461-2252
SPIN-code: 9314-5608
Scopus Author ID: 6504224287
ResearcherId: V-1487-2017
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint PetersburgPavel K. Tyulikov
Kirov Military Medical Academy
Email: tiulikov.pav@mail.ru
ORCID iD: 0009-0006-1669-7836
ResearcherId: ISS-0816-2023
cadet
Russian Federation, Saint PetersburgVladislava S. Mityunina
The S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation, St. Petersburg, Russia
Email: vmityunina01@gmail.com
ORCID iD: 0009-0008-7703-7908
ResearcherId: ISB-6351-2023
cadet
Russian Federation, 194175, Russia, St. Petersburg, Akademika Lebedeva str., 6.Maxim I. Spitsin
Kirov Military Medical Academy
Email: dr.spicynm2@mail.ru
ORCID iD: 0000-0002-2059-7399
SPIN-code: 5303-7104
ResearcherId: ISS-0739-2023
MD, MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgKonstantin E. Korostelev
Kirov Military Medical Academy
Email: neuro-koro@mail.ru
ORCID iD: 0009-0009-1321-9363
SPIN-code: 8004-0658
ResearcherId: ISS-1011-2023
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgKonstantin V. Tyulikov
Kirov Military Medical Academy
Email: sekr@emergency.spb.ru
ORCID iD: 0000-0002-4700-889X
SPIN-code: 6047-9941
ResearcherId: ISS-0358-2023
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgRoman V. Yarmoshuk
Kirov Military Medical Academy
Email: ryarmoshuk@inbox.ru
ORCID iD: 0000-0002-8270-4903
SPIN-code: 1928-0023
ResearcherId: ISS-0755-2023
surgeon
Russian Federation, Saint PetersburgVladimir S. Zhukov
Kirov Military Medical Academy
Email: borh.tri-galki@yandex.ru
ORCID iD: 0009-0006-1027-2474
ResearcherId: ISS-0762-2023
cadet
Russian Federation, Saint PetersburgIsmail K. Ismailov
Kirov Military Medical Academy
Author for correspondence.
Email: ismailov.iskh@mail.ru
ORCID iD: 0009-0000-0582-0575
SPIN-code: 9337-2360
ResearcherId: ISS-0771-2023
cadet
Russian Federation, Saint PetersburgReferences
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