Objective: To investigate the thickness of cranial bone in different parts of children skull during stereotactic electroencephalogram (SEEG) and its effect on electrode fixation. Methods: From October 2016 to March 2017, 13 children with SEEG by robot of surgery assistant (ROSA) were selected. The basic case information and electrode design scheme were collected. The skull thickness of each electrode channel was measured on post-operation CT, and the loosening of the fixed screws were recorded. The thickness of skull in frontal bone, temporal bone, parietal bone and occipital bone was statistically processed by SPSS statistical software. Results: There were total 113 electrodes in 13 children with epilepsy. There were 45 electrodes at frontal bone, of which the thickness was (5.7±2.8)mm. There were 34 electrodes at temporal bone, of which the thickness was (3.5±1.3)mm.There were 16 electrodes at parietal bone, of which the thickness was (6.0±2.5)mm.There were 18 electrodes at occipital bone, of which the thickness was (6.9±0.5)mm. Statistics showed that there was significant difference between differnt bone (F=15.340, P<0.01). There were 4 electrodes loosening, 1 at frontal bone and 3 at temporal bone, when the screws were removed. There was no adverse event related to the implantation of electrodes. Conclusions: The children's skull thickness is thinner than adults. The screw loosening is exist in some cases, but it has no effect on SEEG recording. No SEEG related adverse events are found in this group. Therefore, ROSA guided SEEG is safe and reliable in children with epilepsy.
目的: 探讨立体定向脑电图(SEEG)时儿童不同部位的颅骨厚度对电极固定的影响。 方法: 选取2016年10月至2017年3月在北京儿童医院接受机器人立体定向辅助系统(ROSA)下SEEG患儿13例,搜集基本病例信息,电极设计方案,在术后CT上测量每个电极通道的颅骨厚度,记录拔除固定螺丝时的松动情况。应用SPSS统计软件,对额骨、颞骨、顶骨、枕骨上的电极通道处的颅骨厚度进行统计处理。 结果: 13例癫痫患儿共植入113根颅内电极,其中额骨45根,颅骨厚度为(5.7±2.8)mm;颞骨34根,颅骨厚度为(3.5±1.3)mm,最小值为1.75 mm;顶骨16根,颅骨厚度为(6.0±2.5)mm;枕骨18根,颅骨厚度为(6.9±0.5)mm;不同颅骨间颅骨厚度差异有统计学意义(F=15.340,P<0.01)。拔除固定螺丝时共有4例出现松动,1例位于额骨,3例位于颞骨。无任何植入电极相关不良事件发生。 结论: 儿童颅骨相对成人要薄,个别可出现螺丝松动情况,但是对记录脑电信号无影响。未发现SEEG相关的不良事件,故在儿童癫痫中应用ROSA引导下的SEEG安全可靠。.
Keywords: Epilepsy; Pediatric patient; Skull thickness; Stereotactic electroencephalogram.