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A Unique Model for Ultrasound Assessment of Optic Nerve Sheath Diameter

Published online by Cambridge University Press:  23 September 2014

Frederick A. Zeiler ,
Bertram Unger ,
Andreas H. Kramer ,
Andrew W. Kirkpatrick  and
Lawrence M. Gillman
Frederick A. Zeiler*
Affiliation:
Section of Neurosurgery, University of Manitoba, Winnipeg, Manitoba
Bertram Unger
Affiliation:
Department of Surgery, Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba Department of Medical Education, University of Manitoba, Winnipeg, Manitoba
Andreas H. Kramer
Affiliation:
Critical Care, University of Calgary, Calgary, Alberta, Canada Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Andrew W. Kirkpatrick
Affiliation:
Section of General Surgery, Department of Surgery, Regional Trauma Services, University of Calgary, Calgary, Alberta, Canada Critical Care, University of Calgary, Calgary, Alberta, Canada
Lawrence M. Gillman
Affiliation:
Section of General Surgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba Department of Surgery, Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba
*
Section of Neurosurgery, Dept of Surgery, University of Manitoba, GB-1 Health Sciences Center, 820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. Email: umzeiler@cc.umanitoba.ca.
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Abstract

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Background:

Ultrasonic assessment of optic nerve sheath diameter (ONSD) as a non-invasive measure of intracranial pressure (ICP) has been evaluated in the literature as a potential valid technique for rapid ICP estimation in the absence of invasive intracranial monitoring. The technique can be challenging to perform and little literature exists surrounding intra-operator variability.

Objectives:

In this study we describe the creation of a novel model of ONSD to be utilized in ultrasound training of this technique. We demonstrate the realistic ultrasonographic images created utilizing this novel model.

Methods:

We designed ocular models composed of gelatin spheres and variable three dimensional printed cylinders, which simulate the globe of the eye and variable ONSD's respectively. These models were suspended in a gelatin background and ultrasound of the ONSD was conducted using standard techniques described in the literature.

Results:

This model produces clear and accurate representation of ONSD that closely mimics in vivo images. It is affordable and easy to produce in large quantities, portending its use in an educational environment.

Conclusions:

Utilizing the standard linear array ultrasound probe for ONSD measurements in our model provided realistic images comparable to in vivo. This provides an affordable and exciting means to test intra- and inter- operator variability in a standardized environment. Knowing this, we can further apply this novel model of ONSD to ultrasound teaching and training courses with confidence in its ability and the technique's ability to produce consistent results.

Résumé:

Résumé:Contexte:

L'évaluation par ultrasonographie du diamètre de la gaine du nerf optique (DGNO) comme mesure non effractive de la pression intracrânienne (PIC) est considérée selon la littérature comme une technique potentiellement valide d'estimation rapide de la PIC, en l'absence de monitoring intracrânien effractif. Effectuer la technique peut présenter un défi et il y a peu de publications concernant la variabilité intra-opérateur.

Objectifs:

Nous décrivons un nouveau modèle d'évaluation par ultrasonographie du DGNO que nous avons conçu pour l'enseignement de cette technique. Nous montrons des images ultrasonographiques réalistes créées au moyen de ce nouveau modèle.

Méthode:

Nous avons conçu des modèles oculaires composés de sphères de gélatine et des cylindres imprimés variables à trois dimensions qui simulent respectivement le globe oculaire et différents DGNO. Ces modèles sont suspendus devant une toile de fond de gélatine et l'ultrasonographie du DGNO est ensuite effectuée par la technique standard décrite dans la littérature.

Résultats:

Ce modèle donne une représentation claire et exacte du DGNO qui imite fidèlement les images captées in vivo. Il est d'un prix abordable et facile à produire en grande quantité, ce qui laisse présager qu'il sera utilisé pour l'enseignement.

Conclusions:

L'utilisation de la sonde à ultrasons en réseau linéaire pour la mesure du DGNO dans notre modèle a donné des images réaliste, comparables à celles obtenues in vivo. C'est donc un moyen abordable et attrayant d'évaluation de la variabilité intra et inter opérateur dans un environnement standardisé. Nous pouvons donc utiliser ce nouveau modèle de DGNO pour l'enseignement et l'entraînement du personnel tout en étant confiant que le modèle et la technique produiront des résultats concordants.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 2 , March 2013 , pp. 225 - 229
Copyright
Copyright © The Canadian Journal of Neurological 2013

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