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Targeting Epilepsy Through the Foremen Ovale: How Many Helical Needles are Needed?

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Abstract

Laser ablation of the hippocampus offers medically refractory epilepsy patients an alternative to invasive surgeries. Emerging commercial solutions deliver the ablator through a burr hole in the back of the head. We recently introduced a new access path through the foremen ovale, using a helical needle, which minimizes the amount of healthy brain tissue the needle must pass through on its way to the hippocampus, and also enables the needle to follow the medial axis of the hippocampus more closely. In this paper, we investigate whether helical needles should be designed and fabricated on a patient-specific basis as we had previously proposed, or whether a small collection of pre-defined needle shapes can apply across many patients. We propose a new optimization strategy to determine this needle set using patient data, and investigate the accuracy with which these needles can reach the the medial axis of the hippocampus. We find that three basic tube shapes (mirrored as necessary for left vs. right hippocampi) are all that is required, across 20 patient datasets (obtained from 10 patient CT scans), to reduce worst-case maximum error below 2 mm.

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Acknowledgments

This work was supported in part by the National Institutes of Health (NIH) under R01 NS120518. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funding

This work was supported in part by the National Institutes of Health (NIH) under R01 NS120518. Vanderbilt University has filed patents related to the technology described in this paper. The most relevant is US Patent Number 10321963.

Conflict of interest

There are no financial interests or potential conflict of interest related to this work to disclose.

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Authors and Affiliations

  1. Mechanical Engineering Department, Vanderbilt University, Nashville, TN, USA

    J. Granna, E. B. Pitt, M. E. McKay, E. J. Barth & R. J. Webster III

  2. Vanderbilt Institute for Surgery and Engineering (VISE), Nashville, TN, USA

    J. Granna, E. B. Pitt, M. E. McKay, D. J. Englot, R. P. Naftel, E. J. Barth & R. J. Webster III

  3. Vanderbilt University Medical Center, Nashville, TN, USA

    T. J. Ball, D. J. Englot, R. P. Naftel & R. J. Webster III

  4. University of Louisville School of Medicine, Louisville, KT, USA

    J. S. Neimat

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  1. J. Granna
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Correspondence to R. J. Webster III.

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Associate Editor Ka-Wai Kwok oversaw the review of this article.

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Granna, J., Pitt, E.B., McKay, M.E. et al. Targeting Epilepsy Through the Foremen Ovale: How Many Helical Needles are Needed?. Ann Biomed Eng 50, 499–506 (2022). https://doi.org/10.1007/s10439-022-02929-w

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  • DOI: https://doi.org/10.1007/s10439-022-02929-w

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