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Child's Nervous System

, Volume 34, Issue 5, pp 853–859 | Cite as

The use of a smartphone-assisted ventricle catheter guide for Ommaya reservoir placement—experience of a retrospective bi-center study

  • Sergey Ozerov
  • U. W. Thomale
  • M. Schulz
  • A. Schaumann
  • A. Samarin
  • E. Kumirova
Original Paper

Abstract

Background

For intraventricular chemotherapy (IVC) as part of many oncological treatment protocols, Ommaya reservoir is enabling repeated access to the cerebro-spinal fluid (CSF). The correct placement of the catheter in the ventricle is essential for correct application of drugs, which is enabled by sophisticated techniques such as neuronavigation.

Objective

In a bi-center retrospective study, we reviewed our experience using a smartphone-assisted ventricle catheter guide as simple solution for correct Ommaya reservoir placement.

Methods

Sixty Ommaya reservoirs have been placed in 60 patients between 2011 and 2017 with the smartphone-assisted ventricular catheter guidance technique. Patient characteristics, preoperative frontal and occipital horn ratio (FOHR), postoperative catheter position, and complications were assessed.

Results

The majority of our patients (71.6%) have got narrow or slit-like ventricles (FOHR ≤ 0.4). All Ommaya reservoirs were placed successfully. Fifty-eight ventricular catheters (97%) were inserted at the first and 2 (3%) at the second attempt using the same technique. No immediate perioperative complications were observed. All catheters (100%) could be used for IVC. Postoperative imaging was available in 52 patients. Thirty-two (61.5%) of ventricular catheters were rated as grade I, 20 (38.5%) as grade II, and none (0%) as grade III. Four patients (6.7%) showed postoperative complications during a median follow-up of 8.5 months (hydrocephalus, n = 1; infection, n = 1; parenchymal cyst around catheter, n = 1; shunt revision, n = 1).

Conclusions

The smartphone-assisted guide offers decent accuracy of ventricle catheter placement with ease and simplicity for a small surgical intervention. We propose this technique as routine tool for Ommaya reservoir placement independent of lateral ventricular size to decrease the rate of ventricle catheter malposition as reasonable alternative to a neuronavigation system.

Keywords

Ommaya reservoir Ventricular access device (VAD) Intrathecal chemotherapy (IVC) Ventricular catheter Neuronavigation Stereotaxy Thomale guide 

Notes

Compliance with ethical standards

Conflict of interest

UWT holds a patent on the guiding instrument. UWT and AS received lecture honorarium from Miethke Aesculap Comp. in the past. All other authors have no conflict of interest to declare.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Sergey Ozerov
    • 1
  • U. W. Thomale
    • 2
  • M. Schulz
    • 2
  • A. Schaumann
    • 2
  • A. Samarin
    • 1
  • E. Kumirova
    • 1
  1. 1.Pediatric Neurosurgery and Neurooncology DepartmentDmitry Rogachev National Research Center of Pediatric Hematology, Oncology and ImmunologyMoscowRussia
  2. 2.Pediatric Neurosurgery, Campus Virchow KlinikumCharité UniversitaetsmedizinBerlinGermany

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