BrainPort Research Articles

Qualitative Study for the Design and Fabricate of Assistive Technologies for the Visually Impaired and Blind People to Improve the Quality of Life

From the distant past until now, various assistive devices and equipment have been made and marketed for the purpose of improving the life of blind people. Braille and the white cane can be noted as one of the most basic auxiliary equipment for the blind people. Over time and through the advancement of technology, a great change has taken place in the world of the blinds; and we can see everyday development of various tools which all of them are useful in improving the life of the blind people. Today, there are various helpful tools for the blind including Obstacle detection gadgets, Text reading tools, Money detection systems, Routing systems, Audio clock, Brain port, Braille tablet, Artificial eyes (bionic eyes), etc. In this article, we will have an overview of assistive devices made for the blinds. Examination of the produced medical equipment in this field will make it possible to provide more qualified assistive equipment for the blind.

A design of brain port with a built-in bi-directional check valve improves the ventriculostomy.

The increase of intracranial pressure is a life-threatening condition which requires urgent treatment to prevent the further neurologic problem. A design of the brain port is proposed, in which a bi-directional check valve controls the flow of the cerebrospinal fluid depending on the intracranial pressure in accordance with the other devices. Drug administration and cerebrospinal fluid drainage could be performed easily without any additional surgery other than the transplant of a brain port. The intracranial pressure value at which the cerebrospinal fluid should be drained is adjustable by altering the pressure of the drainage bag. The results of the experiment with the simulated brain system are supporting and verifying the substance of this article.

Minimally Invasive Brain Port Approach for Accessing Deep-Seated Lesions Using Simple Syringe

Retraction-related injury is a recognized complication in neurosurgery. Use of tubular retractors that distribute the pressure on brain tissue was introduced to minimize brain injury. We developed a modified technique using a simple plastic syringe with a Foley catheter to achieve atraumatic cannulation in accessing deep lesions. A retrospective pilot study was conducted to assess safety of the syringe transtubular technique for accessing deep lesions as a cost-effective substitute for commercial brain port methods and to identify retraction-related injury using diffusion-weighted magnetic resonance imaging postoperatively. Nine patients were operated on using the syringe technique. Lesions selected were intraparenchymal, deeply located in the supratentorial compartment. Lesions were located in the insula (n= 2), thalamus or basal ganglia (n= 5), subcortical frontoparietal (n= 1) lobe, and right temporal lobe (n= 1). Patients with hematomas, intraventricular lesions, superficially located lesions; pediatric patients less than 12 years old; and patients undergoing redo surgeries were excluded. Surgical goals were achieved in 8 patients. Three patients had transient deficits; one patient had significant morbidity, which was diagnosed postoperatively as toxoplasmosis. Diffusion restriction was noted in all patients at the surgical cavity but not in the cannulation path. Transtubular approaches have a good safety profile and can help achieve surgical goals. Larger studies are needed to compare this approach with other methods, including its effect on hospital stay and survival. The syringe technique is an alternative safe method that can be used in certain neurosurgical centers where commercial tube systems are unavailable.

Syringe Port: A Convenient, Safe, and Cost-Effective Tubular Retractor for Transportal Removal of Deep-Seated Lesions of the Brain.

Minimally invasive transportal resection of deep intracranial lesions has become a widely accepted surgical technique. Many disposable, mountable port systems are available in the market for this purpose, like the ViewSite Brain Access System. The objective of this study was to find a cost-effective substitute for these systems. Deep-seated brain lesions were treated with a port system made from disposable syringes. The syringe port could be inserted through minicraniotomies placed and planned with navigation. All deep-seated lesions like ventricular tumours, colloid cysts, deep-seated gliomas, and basal ganglia hemorrhages were treated with this syringe port system and evaluated for safety, operative site hematomas, and blood loss. 62 patients were operated on during the study period from January 2015 to July 2017, using this innovative syringe port system for deep-seated lesions of the brain. No operative site hematoma or contusions were seen along the port entry site and tract. Syringe port is a cost-effective and safe alternative to the costly disposable brain port systems, especially for neurosurgical setups in developing countries for minimally invasive transportal resection of deep brain lesions.

Utility of Electro-Tactile (Brain Port®) Stimulation in Vestibular Rehabilitation

Utility of Electro-Tactile (Brain Port®) Stimulation in Vestibular Rehabilitation

Rehabilitation of patients after ear surgery: prospects of auditory and vestibular training in non­invasive neuromodulation

The objective of the research is to evaluate the efficacy of rehabilitation in 73 patients with hearing and vestibulation impairment after ear surgery. Rehabilitation had the form of a set of auditory and vestibular training in conditions of non­invasive neuromodulation. Vestibular training had the form of an exercise on equilibrium control with the eyes closed performed with the help of Brain Port device during a week after surgery. Audial training was a 10-days acoustic stimulation on the expiry of 1 month after surgery. In both cases non­invasive neuromodulation was provided by electrotactile stimulation of tongue using Brain Port device. The data of tone threshold audiometry, speech intelligibility in conditions of speech interference, computerized posturography and gate examination were evaluated. The results confirm effectiveness of the used rehabilitation activities for speech intelligibility and gait improvement in majority of the patients.

Hemostasis Management during Completely Endoscopic Removal of a Highly Vascular Intraparenchymal Brain Tumor: Technique Assessment

Recently, stereotactic-guided removal of intraparenchymal lesions using endoscopic visualization through a brain port has been successfully reported. Although endoneurosurgical tumor resection uses the same principles as those used in microneurosurgery, the ability to control bleeding through the port requires an adapted technique. We present a patient that underwent a completely endoscopic resection of a vascular brain tumor through a brain port and describe the hemostatic technique. A 68 year-old female presented with progressive gait difficulties. She had been previously treated for a breast cancer. Magnetic resonance imaging (MRI) showed a right subcortical solitary cerebellar lesion that homogeneously enhanced. The patient underwent an endoscopic brain port removal of a supposed brain metastasis. After port cannulation, the tumor partly delivered itself into the port. Following initial tumor biopsy, active bleeding occurred. Irrigation and application of Surgifoam allowed to control the bleeding. Coagulation with an adapted bipolar and removal of coagulated tissue with the side-cutting aspiration device were sequentially repeated. Once the tumor was resected, the suction served as counter-traction elongating the vessels whereas the bipolar cauterized them over a long segment. Hemostasis was performed circumferentially along the cavity's walls from deep to superficial, benefiting from the endoscope's dynamic properties and magnification. Pathology confirmed intraoperative suspicion of hemangioblastoma. Removal of vascular tumors is feasible through the brain port, despite a relatively narrow corridor of 11.5 mm. However, specific hemostasis techniques are required and adapted instruments are needed to ensure hemostasis through these small corridors.

Side-Cutting Aspiration Device for Endoscopic and Microscopic Tumor Removal

The authors present a unique side-cutting instrument (NICO Myriad, Indianapolis, IN) with variable aspiration designed specifically for tumor resection. The study included retrospective review of data collected from 10/2009 to 01/2011. We detail the use of the Myriad in 31 patients with the following pathologies: meningioma (n=16), chordoma (n = 3), schwannoma (n = 3), pituitary adenoma (n = 2), metastasis (n = 3), hemangioblastoma (n = 1), craniopharyngioma (n = 1), and nasopharyngeal tumors (n = 2). Surgical approaches included expanded endonasal approach (n = 19), endoscopic brain port (n = 3), supraorbital "eyebrow" craniotomy (n = 3), retrosigmoid suboccipital craniotomy (n = 3), pterional craniotomy (n = 1), extreme far lateral (n = 1), and laminectomy (n = 1). Successful tumor resection was achieved in 30 cases. Instrument failure was noted in only one extremely fibrous meningioma. The design of this instrument facilitated maneuvering through narrow corridors while providing direct visualization of the suction aperture during tumor resection. These features allowed for tumor removal without injury to adjacent neurovascular structures. The side-cutting aspiration device allows safe and effective tumor removal. Its low profile, variable aspiration, and lack of thermal heat energy are particularly useful in tumor resection through narrow corridors, such as endonasal, port, and keyhole approaches. The multifunctional nature of the instrument (suction, scissors, and dissectors) minimizes multiple exchanges, facilitating tumor resection through these minimal access corridors.

ERES Conference 2011: sharing knowledge in Brainport Eindhoven

ERES Conference 2011: sharing knowledge in Brainport Eindhoven

Lymphopenia caused by cranial irradiation in children receiving craniospinal radiotherapy.

The peripheral blood changes were studied in 67 children who received craniospinal irradiation for posterior fossa tumors. At the completion of a cranial dose of about 3500 rad to the whole brain port, the lymphocytes were reduced to 858/mm3 rom 3084/mm3 preoperatively. The counts of the remaining leukocytes stayed at a level somewhat higher than preoperatively; the eosinophils rose to 288/mm3 from 125/mm3. With the initiation of the spinal field irradiation, which included a large proportion of the total bone marrow, the numbers of all the leukocytes decreased rapidly; the observed leukopenia was mainly secondary to neutropenia. A mechanism that was operating to restore the number of leukocytes became manifest immediately after the completion of radiotherapy, though the number of lymphocytes had not been totally restored to the preoperative level 6 years later. Irradiation of the lymphocytes that circulate through the vascular bed can explain the lymphopenia observed during cranial radiotherapy. Mild leukopenia observed in patients receiving radiotherapy through a relatively small port may be secondary to lymphopenia, and this does not necessarily indicate impaired bone marrow reserves.