====== Thomale Guide ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1NOY_AEF8gNQ3GQ4zpjMROCSZdYT15fax2WYqFMYQrkIBg9kh_/?limit=15&utm_campaign=pubmed-2&fc=20240214002524}}

https://www.miethke.com/en/products/instruments/thomale-guide

see [[Freehand ventricular catheter placement]]

[[External ventricular drain]] (EVD) [[implantation]] is one of the fundamental [[procedure]]s of [[neurosurgical emergency]] usually performed freehand at the [[bedside]] or in the [[operating room]] using [[anatomical landmarks]]. However, this [[technique]] is frequently associated with [[malpositioning]] leading to [[complications]] or [[dysfunction]]. 

Sargut et al. from the [[Charité]] and Cantonal Hospital of [[Lucerne]], describe a [[novel]] navigated bedside EVD [[insertion]] [[technique]], which is evaluated in a clinical [[case series]] with the aim of [[safety]], [[accuracy]], and [[efficiency]] in [[neurosurgical emergency]] settings.

From [[2021]] to [[2022]], a [[mobile]] health-assisted [[navigation]] [[instrument]] (Thomale Guide, Christoph [[Miethke]], Potsdam, Germany) was used alongside a battery-powered single-use [[drill]] ([[Phasor Health]], Houston, USA) for bedside [[EVD]] [[placement]] in representative neurosurgical pathologies in emergencies requiring ventricular [[cerebrospinal fluid]] (CSF) relief and [[intracranial pressure monitoring]].

In all 12 patients (8 female and 4 male), navigated bedside EVDs were placed around the [[foramen of Monro]] at the first [[ventriculostomy]] attempt. The most frequent indication was [[aneurysmal subarachnoid hemorrhage]]. Mean [[operating time]] was 25.8 ± 15.0 min. None of the EVDs had to be revised due to [[malpositioning]] or [[dysfunction]]. Two EVDs were converted into a [[ventriculoperitoneal shunt]]. Drainage volume was 41.3 ± 37.1 ml per day in the mean. The mean [[length of stay]] of an EVD was 6.25 ± 2.8 days. Complications included one postoperative [[subdural hematoma]] and [[cerebrospinal fluid infection]], respectively.

Combining mobile health-assisted navigation [[instrument]] with a battery-powered [[drill]] and an appropriate [[ventricular catheter]] may enable and enhance safety, accuracy, and efficiency in bedside EVD implantation in various pathologies of emergency neurosurgery without adding relevant efforts
((Sargut TA, Thomale UW, Schulz M, Schaumann A, Schneider UC, Bayerl SH,
Spindler P, Vajkoczy P, Ferdowssian K. Navigated bedside implantation of
external ventricular drains with mobile health guidance: technical note and case
series. Acta Neurochir (Wien). 2024 Feb 10;166(1):76. doi:
10.1007/s00701-024-05955-w. PMID: 38340225.))
----
2: Roethe AL, Beer L, Schulz M, Schaumann A, Thomale UW. Tailored concept for
accurate neuroendoscopy: a comparative retrospective single-center study on
image-guided neuroendoscopic procedures - technical note. World Neurosurg. 2024
Feb 5:S1878-8750(24)00192-X. doi: 10.1016/j.wneu.2024.01.171. Epub ahead of
print. PMID: 38325702.

4: Spindler P, Fiss I, Giese H, Hermann E, Lemcke J, Schuhmann MU, Thomale UW,
Schaumann A. Angulation Toward Coronal Convexity Measure and Catheter Length
Indication Improves the Quality of Ventricular Catheter Placement-A Smartphone-
Assisted Guidance Technique. World Neurosurg. 2022 Mar;159:e221-e231. doi:
10.1016/j.wneu.2021.12.036. Epub 2021 Dec 23. PMID: 34954440.

5: Condino S, Montemurro N, Cattari N, D'Amato R, Thomale U, Ferrari V, Cutolo
F. Evaluation of a Wearable AR Platform for Guiding Complex Craniotomies in
Neurosurgery. Ann Biomed Eng. 2021 Sep;49(9):2590-2605. doi:
10.1007/s10439-021-02834-8. Epub 2021 Jul 23. PMID: 34297263.

6: Thomale UW. Integrated understanding of hydrocephalus - a practical approach
for a complex disease. Childs Nerv Syst. 2021 Nov;37(11):3313-3324. doi:
10.1007/s00381-021-05243-3. Epub 2021 Jun 10. PMID: 34114082; PMCID: PMC8578093.


8: Pennacchietti V, Prinz V, Schaumann A, Finger T, Schulz M, Thomale UW. Single
center experiences with telemetric intracranial pressure measurements in
patients with CSF circulation disturbances. Acta Neurochir (Wien). 2020
Oct;162(10):2487-2497. doi: 10.1007/s00701-020-04421-7. Epub 2020 Jun 3. PMID:
32495080; PMCID: PMC7496065.


10: Ozerov S, Thomale UW, Schulz M, Schaumann A, Samarin A, Kumirova E. The use
of a smartphone-assisted ventricle catheter guide for Ommaya reservoir
placement-experience of a retrospective bi-center study. Childs Nerv Syst. 2018
May;34(5):853-859. doi: 10.1007/s00381-017-3713-6. Epub 2018 Jan 10. PMID:
29322340.

11: Thomale UW, Schaumann A, Stockhammer F, Giese H, Schuster D, Kästner S,
Ahmadi AS, Polemikos M, Bock HC, Gölz L, Lemcke J, Hermann E, Schuhmann MU, Beez
T, Fritsch M, Orakcioglu B, Vajkoczy P, Rohde V, Bohner G. GAVCA Study:
Randomized, Multicenter Trial to Evaluate the Quality of Ventricular Catheter
Placement with a Mobile Health Assisted Guidance Technique. Neurosurgery. 2018
Aug 1;83(2):252-262. doi: 10.1093/neuros/nyx420. PMID: 28973670; PMCID:
PMC6140776.


13: Ozerov SS, Samarin AE, Mel'nikov AV, Kumirova EV. Ustanovka ventrikuliarnogo
katetera v uzkie bokovye zheludochki. Navigatsiia dlia vsekh [Placement of a
ventricular catheter into narrow lateral ventricles. Popular navigation]. Zh
Vopr Neirokhir Im N N Burdenko. 2017;81(2):72-76. Russian. doi:
10.17116/neiro201781272-76. PMID: 28524128.


15: Schaumann A, Thomale UW. Guided Application of Ventricular Catheters
(GAVCA)--multicentre study to compare the ventricular catheter position after
use of a catheter guide versus freehand application: study protocol for a
randomised trail. Trials. 2013 Dec 12;14:428. doi: 10.1186/1745-6215-14-428.
PMID: 24330776; PMCID: PMC3866392.

16: Freimann FB, Schulz M, Haberl H, Thomale UW. Feasibility of telemetric ICP-
guided valve adjustments for complex shunt therapy. Childs Nerv Syst. 2014
Apr;30(4):689-97. doi: 10.1007/s00381-013-2324-0. Epub 2013 Nov 22. PMID:
24264382.


18: Thomale UW, Knitter T, Schaumann A, Ahmadi SA, Ziegler P, Schulz M, Miethke
C. Smartphone-assisted guide for the placement of ventricular catheters. Childs
Nerv Syst. 2013 Jan;29(1):131-9. doi: 10.1007/s00381-012-1943-1. Epub 2012 Oct
23. PMID: 23089936.

19: Thomale UW, Tyler B, Renard V, Dorfman B, Chacko VP, Carson BS, Haberl EJ,
Jallo GI. Neurological grading, survival, MR imaging, and histological
evaluation in the rat brainstem glioma model. Childs Nerv Syst. 2009
Apr;25(4):433-41. doi: 10.1007/s00381-008-0767-5. Epub 2008 Dec 10. PMID:
19082613.

20: Thomale UW, Tyler B, Renard VM, Dorfman B, Guarnieri M, Haberl HE, Jallo GI.
Local chemotherapy in the rat brainstem with multiple catheters: a feasibility
study. Childs Nerv Syst. 2009 Jan;25(1):21-8. doi: 10.1007/s00381-008-0684-7.
Epub 2008 Aug 9. PMID: 18690465.

21: Thomale UW, Griebenow M, Mautes A, Beyer TF, Dohse NK, Stroop R, Sakowitz
OW, Unterberg AW, Stover JF. Heterogeneous regional and temporal energetic
impairment following controlled cortical impact injury in rats. Neurol Res. 2007
Sep;29(6):594-603. doi: 10.1179/016164107X166272. PMID: 17535559.

22: Thomale UW, Stover JF, Unterberg AW. The use of neuronavigation in
transnasal transsphenoidal pituitary surgery. Zentralbl Neurochir. 2005
Aug;66(3):126-32; discussion 132. doi: 10.1055/s-2005-836602. PMID: 16116555.

23: Rohlfing T, West JB, Beier J, Liebig T, Taschner CA, Thomale UW.
Registration of functional and anatomical MRI: accuracy assessment and
application in navigated neurosurgery. Comput Aided Surg. 2000;5(6):414-25. doi:
10.1002/igs.1003. PMID: 11295854.