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Article

Linear Oblique Craniectomy: A Novel Method of Minimally Invasive Subdural Grid Insertion

by
Calvin W Howard
1,
Nader S Aboelnazar
1,
Noor Salem
1,2,
Naweed Syed
3,4 and
Lian Willetts
1,3,*
1
Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
2
Ministry of Higher Education, Kuwait City 27130, Kuwait
3
Department of Cell Biology and Anatomy, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 1N4, Canada
4
Alberta Children’s Hospital Research Institute, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
*
Author to whom correspondence should be addressed.
Clin. Transl. Neurosci. 2020, 4(2), 18; https://doi.org/10.1177/2514183x20973085
Submission received: 13 July 2020 / Accepted: 22 October 2020 / Published: 26 November 2020

Abstract

Background: Many countries rely upon subdural grid electroencephalography in the planning of epilepsy surgeries. However, craniotomy for subdural grid implantation is known to result in a variety of complications and requires diligence from the surgical team. We describe a minimally invasive method of subdural grid insertion, termed the linear oblique craniectomy, designed to mitigate complications and increase ease of subdural grid insertion. Objective: To demonstrate feasibility of minimally invasive subdural grid insertion utilizing skull anatomy. Methods: Three fresh frozen and embalmed human cadavers underwent surface landmarking and craniectomy to introduce a 4 × 5 cm2 subdural grid over the Sylvian fissure. Anteroposterior lens-shaped craniectomy measured 5 cm in length with 1 cm maximal width. The dura mater was longitudinally incised, and subdural grids were introduced over the Sylvian fissure. Results: The total area of the craniectomy created by the linear oblique approach consists of only approximately 20% of the total area removed by the traditional approach to access the Sylvian fissure for mesial temporal epilepsy monitoring/preoperative planning. The locations of the grids were evaluated by MRI and computed tomography scans postoperatively to ensure accurate alignment with the Sylvian fissure. Conclusion: In this cadaveric study, we demonstrate the linear oblique craniectomy procedure that provides an alternative approach to subdural grid implantation with significantly decreased invasiveness. This surgical approach has the potential of reducing complication rates of subdural grid insertion for surface monitoring of the brain activity and/or neuromachine interface analysis and is associated with significant reduction of surgical time.
Keywords: craniectomy; electroencephalography; grid; linear; oblique; subdural craniectomy; electroencephalography; grid; linear; oblique; subdural

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MDPI and ACS Style

Howard, C.W.; Aboelnazar, N.S.; Salem, N.; Syed, N.; Willetts, L. Linear Oblique Craniectomy: A Novel Method of Minimally Invasive Subdural Grid Insertion. Clin. Transl. Neurosci. 2020, 4, 18. https://doi.org/10.1177/2514183x20973085

AMA Style

Howard CW, Aboelnazar NS, Salem N, Syed N, Willetts L. Linear Oblique Craniectomy: A Novel Method of Minimally Invasive Subdural Grid Insertion. Clinical and Translational Neuroscience. 2020; 4(2):18. https://doi.org/10.1177/2514183x20973085

Chicago/Turabian Style

Howard, Calvin W, Nader S Aboelnazar, Noor Salem, Naweed Syed, and Lian Willetts. 2020. "Linear Oblique Craniectomy: A Novel Method of Minimally Invasive Subdural Grid Insertion" Clinical and Translational Neuroscience 4, no. 2: 18. https://doi.org/10.1177/2514183x20973085

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