BACKGROUND: Intracranial depth electrodes for epilepsy are easily dislodged during long-term monitoring unless adequately anchored, but a technique is not available that is both secure and allows easy explantation without reopening the incision.
OBJECTIVE: To describe a convenient and inexpensive method for anchoring depth electrodes that prevents migration and incidental pullout while allowing electrode removal at the bedside.
METHODS: An easily breakable suture (eg, MONOCRYL) is tied around both the depth electrode and a heavy nylon suture and anchored to a hole at the edge of the burr hole; the tails of both are tunneled together percutaneously. The “break-away” MONOCRYL suture effectively anchors the electrode for as long as needed. At the completion of the intracranial electroencephalography session, the 2 tails of the nylon suture are pulled to break their encompassing MONOCRYL anchor suture, thus freeing the depth electrode for easy removal.
RESULTS: The break-away depth electrode anchoring technique was used for 438 electrodes in 68 patients, followed by explantation of these and associated strip electrodes without reopening the incision. Only 1 electrode (0.2%) migrated spontaneously, and 3 depth electrodes (0.7%) fractured in 2 patients (2.9%) on explantation, necessitating open surgery to remove them in 1 of the patients (1.5%).
CONCLUSION: An easy and inexpensive anchoring configuration for depth electrodes is described that provides an effective and safe means of securing the electrodes while allowing easy explantation at the bedside.
ABBREVIATION: iEEG, intracranial electroencephalography
Departments of *Neurosurgery and
‡Emory University School of Medicine, Atlanta, Georgia
§Department of Neurological Surgery, University of California, San Francisco, California
‖Department of Biology, Georgia Institute of Technology, Atlanta, Georgia
#Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
Correspondence: Robert E. Gross, MD, PhD, Department of Neurosurgery, Emory University School of Medicine, 1365B Clifton Road NE, Suite 6200, Atlanta, GA 30322. E-mail: email@example.com
Received October 28, 2011
Accepted February 24, 2012