Anchoring Depth Electrodes for Bedside Removal: A "Break-Away" Suturing Technique for Intracranial Monitoring

作者：Gross Robert E^*; Rowland Nathan C; Sung Edward K; LaBorde David V; Suleiman Shadeah L

来源：Neurosurgery, 2012, 71: 52-56.

DOI：10.1227/NEU.0b013e1825569c0

• Depth electrode
• Epilepsy surgery
• Epileptogenic focus
• Intracranial electroencephalography
• Intracranial monitoring

BACKGROUND: Intracranial depth electrodes for epilepsy are easily dislodged during long-term monitoring unless adequately anchored, but a technique is not available that is both secure and allows easy explantation without reopening the incision.
OBJECTIVE: To describe a convenient and inexpensive method for anchoring depth electrodes that prevents migration and incidental pullout while allowing electrode removal at the bedside.
METHODS: An easily breakable suture (eg, MONOCRYL) is tied around both the depth electrode and a heavy nylon suture and anchored to a hole at the edge of the burr hole; the tails of both are tunneled together percutaneously. The "break-away" MONOCRYL suture effectively anchors the electrode for as long as needed. At the completion of the intracranial electroencephalography session, the 2 tails of the nylon suture are pulled to break their encompassing MONOCRYL anchor suture, thus freeing the depth electrode for easy removal.
RESULTS: The break-away depth electrode anchoring technique was used for 438 electrodes in 68 patients, followed by explantation of these and associated strip electrodes without reopening the incision. Only 1 electrode (0.2%) migrated spontaneously, and 3 depth electrodes (0.7%) fractured in 2 patients (2.9%) on explantation, necessitating open surgery to remove them in 1 of the patients (1.5%).
CONCLUSION: An easy and inexpensive anchoring configuration for depth electrodes is described that provides an effective and safe means of securing the electrodes while allowing easy explantation at the bedside.

• 出版日期2012-9