sEVD-smartphone-navigated placement of external ventricular drains.

Eisenring, Christian V.; Burn, Felice; Baumann, Michelle; Stieglitz, Lennart H.; Kockro, Ralf A.; Beck, Jürgen; Raabe, Andreas; Oertel, Markus F. (2020). sEVD-smartphone-navigated placement of external ventricular drains. Acta neurochirurgica, 162(3), pp. 513-521. Springer Vienna 10.1007/s00701-019-04131-9

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BACKGROUND Currently, the trajectory for insertion of an external ventricular drain (EVD) is mainly determined using anatomical landmarks. However, non-assisted implantations frequently require multiple attempts and are associated with EVD malpositioning and complications. The authors evaluated the feasibility and accuracy of a novel smartphone-guided, angle-adjusted technique for assisted implantations of an EVD (sEVD) in both a human artificial head model and a cadaveric head. METHODS After computed tomography (CT), optimal insertion angles and lengths of intracranial trajectories of the EVDs were determined. A smartphone was calibrated to the mid-cranial sagittal line. Twenty EVDs were placed using both the premeasured data and smartphone-adjusted insertion angles, targeting the center of the ipsilateral ventricular frontal horn. The EVD positions were verified with post-interventional CT. RESULTS All 20 sEVDs (head model, 8/20; cadaveric head, 12/20) showed accurate placement in the ipsilateral ventricle. The sEVD tip locations showed a mean target deviation of 1.73° corresponding to 12 mm in the plastic head model, and 3.45° corresponding to 33 mm in the cadaveric head. The mean duration of preoperative measurements on CT data was 3 min, whereas sterile packing, smartphone calibration, drilling, and implantation required 9 min on average. CONCLUSIONS By implementation of an innovative navigation technique, a conventional smartphone was used as a protractor for the insertion of EVDs. Our ex vivo data suggest that smartphone-guided EVD placement offers a precise, rapidly applicable, and patient-individualized freehand technique based on a standard procedure with a simple, cheap, and widely available multifunctional device.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery

UniBE Contributor:

Eisenring, Christian; Beck, Jürgen and Raabe, Andreas


600 Technology > 610 Medicine & health




Springer Vienna




Nicole Söll

Date Deposited:

24 Jan 2020 12:36

Last Modified:

01 Mar 2020 01:34

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

App External ventricular drain Neuronavigation Smartphone Ventriculostomy




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