Abstract
Introduction
We describe a simple but effective modification of the skull clamp, aimed at stabilising the head of very young children, while avoiding the risk of creating a depressed skull fracture, in order to enable the utilisation of image-guidance in such young patients.
Methods
We machined three small perspex discs 3 cm in diameter. On the outer surface of these pads we drilled reception holes for the pins to prevent slippage. To avoid direct contact with the skin, we interfaced a thick pad of soft felt. During intraoperative positioning, the weight of the head was supported by a suction bean-bag placed on the operating table. Hence, the clamp apparatus was employed only to secure the head position, and not to support the weight of the head, thus requiring less clamp force. We employed this modification in three children (aged 9, 13 and 15 months) who required image-guided surgery for brain tumours.
Outcome
In all cases the head remained immobile throughout the operation, making possible the accurate use of image guidance. At the end of the operation, some transient skin redness was noticed in the contact areas, which settled in a few days.
Similar content being viewed by others
References
Fahlbusch R, Ganslandt O, Nimsky C (2000) Intraoperative imaging with open magnetic resonance imaging and neuronavigation. Childs Nerv Syst 16:829–831
Lee M, Rezai AR, Chou J (1994) Depressed skull fractures in children secondary to skull clamp fixation devices. Pediatr Neurosurg 21:174–177; discussion 178
Wagner W, Gaab MR, Schroeder HW, Sehl U, Tschiltschke W (1999) Experiences with cranial neuronavigation in pediatric neurosurgery. Pediatr Neurosurg 31:231–236
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sgouros, S., Grainger, M.C. & McCallin, S. Adaptation of skull clamp for use in image-guided surgery of children in the first 2 years of life. Childs Nerv Syst 21, 148–149 (2005). https://doi.org/10.1007/s00381-004-1069-1
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00381-004-1069-1