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  Localizing device for ventriculostomyUSPTO Application #: 20070010725Title: Localizing device for ventriculostomy Abstract: A localizing apparatus includes a frame, a linear reference marker, and a target marker. The frame includes a first portion fixable to a first anatomical reference point. The linear reference marker is rotatable about the first anatomical reference point to align a second anatomical reference point with the first anatomical reference point. The target marker is rotatable about the first anatomical reference point to establish an angle from the linear reference marker such that the target marker is located in a desired plane. (end of abstract)
Agent: Benesch, Friedlander, Coplan & Aronoff LLP Attn:IPDepartment Docket Clerk - Cleveland, OH, US Inventor: Jeffrey E. Thomas USPTO Applicaton #: 20070010725 - Class: 600309000 (USPTO) Related Patent Categories: Surgery, Diagnostic Testing, Measuring Or Detecting Nonradioactive Constituent Of Body Liquid By Means Placed Against Or In Body Throughout Test The Patent Description & Claims data below is from USPTO Patent Application 20070010725. Brief Patent Description - Full Patent Description - Patent Application Claims
FIELD OF THE INVENTION [0001] The invention generally relates to locating devices. The invention finds particular application in medical devices referencing skull locations with respect to ventricles. BACKGROUND OF THE DISCLOSURE [0002] Most surgical neurological procedures require accurate placement of medical instruments within the patient's brain. A common neurological surgical procedure is a ventriculostomy in which a cerebral ventricle drain, shunt or catheter is implanted. The purpose of the drain or shunt (with or without a transducer or fiberoptic device) is to relieve high pressure cerebrospinal fluid (CSF) in a patient's cerebral ventricles resulting from congenital brain malformations, acute or chronic infections, tumors, intraventricular hemorrhage, normal pressure hydrocephalus or other intracranial space-occupying lesions, as well as to provide a reliable means to measure intracranial pressure or to deliver medication into the cerebrospinal fluid space. [0003] Procedures for the placement of ventricular drains, shunts and catheters rely on the skill of the neurosurgeon. These procedures are often expensive and time consuming. After imaging the brain, the neurosurgeon forms a burr hole in the skull and guides a catheter through the burr hole toward landmarks on the ipsilateral or contralateral of the patient's head. The neurosurgeon must accurately conceptualize the internal topography of the brain during the procedure, and rely on this conceptualization to effectively place the catheter within the cerebral ventricle. In some procedures, the neurosurgeon checks the location of the catheter by imaging another CT scan of the brain following the operation. By verifying the position of the catheter within the brain, the neurosurgeon can effect longer shunt patency and decrease morbidity rates due to shunt malpositioning, as well as assure the accurate delivery of medication within the ventricle and the accurate measurement of intracranial pressure. BRIEF SUMMARY OF THE INVENTION [0004] A localizing apparatus includes a frame, a linear reference marker, and a target marker. The frame includes a first portion fixable to a first anatomical reference point. The linear reference marker is rotatable about the first anatomical reference point to align a second anatomical reference point with the first anatomical reference point. The target marker is rotatable about the first anatomical reference point to establish an angle from the linear reference marker such that the target marker is located in a desired plane. [0005] Another aspect of the invention provides an apparatus to position instruments within a target. The apparatus includes a probe, a reference marker, and a target marker. The probe is configured to attach to a first reference point. The reference marker is configured to rotate about a center axis of the probe including an end configured to align a second reference point with the first reference point. The target marker is configured to rotate about the axis and to be positioned at an angle such that the target marker is located in a plane that transversely passes through the target. [0006] Another aspect provides a localizing apparatus including a frame having a first and second end, an annular guide, a linear reference marker, and a linear target marker. The frame is configured to extend in an arc around a head and has an outer diameter surface and an inner diameter surface. The annular guide extends from the outer diameter surface to the inner diameter surface and is configured to direct the instrument toward the surface of the head. The first end of the frame is configured to fix the frame to a first anatomical reference point. The second end of the frame is configured to fix the frame to a second anatomical reference point. The linear reference marker is configured to rotate about the first end and to align a third anatomical reference point with the first anatomical reference point. The linear target marker is configured to rotate about the first end. The linear target marker is positioned at an angle from the linear reference marker such that the linear target marker is located in a plane that passes through the desired portion of the head. [0007] Yet another aspect of the invention provides a method for localizing a portion of the brain. The method includes locating a first anatomical reference point, extending a first line from the first anatomical reference point to a second anatomical reference point such that the reference points are located in a sagittal plane, positioning a second line in the sagittal plane to pass through the first anatomical reference point at a determined angle from the first line such that the second line is oriented in a transverse plane that passes through the portion of the brain. BRIEF DESCRIPTION OF THE DRAWINGS [0008] FIG. 1 is a schematic diagram of a first embodiment of a localizing device for ventriculostomy; [0009] FIG. 2 is a lateral view of the first embodiment of FIG. 1 donned by a patient; [0010] FIG. 3 is a schematic diagram of a sagittal scan of a brain; [0011] FIG. 4 is a schematic diagram of an axial scan of a hydrocephalic brain; [0012] FIG. 5 is a schematic diagram of a second embodiment of a localizing device for ventriculostomy; and [0013] FIG. 6 is a front view of the second embodiment of FIG. 4 donned by a patient. DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT [0014] Referring now to the drawings, which are not intended to limit the invention but instead illustrate several exemplary embodiments, FIG. 1 illustrates a schematic of a localizing device 10 for ventriculostomy made in accordance with the teachings of the present invention. The localizing device 10 includes a U-shaped frame 12, probes 14, markers 16, 17 and 18, and a protractor 20. The probes 14 are threadedly received in the frame 12 and lie on an axis 19. The markers 16, 17 and 18, and the protractor 20 are rotatably attached to the frame 12 so that the markers 16, 17, 18 and protractor 20 may rotate about the axis 19. The frame 12 may also rotate about the axis 19. When the device 10 is donned by a patient, the probes 14 are fixed to the skull in the external auditory meati and the frame 12, anatomical reference marker 16, perpendicular reference marker 17, target marker 18, and protractor 20 may rotate about the axis 19. [0015] The frame 12 is generally in the shape of an arc. The frame 12 includes a first end 22 and a second end 24. An outer surface 26 and an inner surface 28 of the frame 12 define the inner and outer arc lengths of the frame 12. In the embodiment shown in FIG. 1, the frame 12 is made of a member having a circular cross section. The frame 12, however, may have various cross sections without limiting functionality. The frame 12 is configured with an array of annular or other shaped guides 30 that extend from the outer surface 26 to the inner surface 28 of the frame 12. The guides 30 may extend perpendicular to the inner and outer surfaces 28 and 26 or may be angled to direct an instrument toward a specific region under the frame 12. By adjusting the angle and the lateral placement of the guides 30 on the frame 12, a neurosurgeon may choose alternative paths to the target. [0016] The markers 16, 17, 18 are relatively positioned with respect to one of the probes 14 so that a neurosurgeon may reference certain anatomical points or planes as the portion of the brain is isolated for the ventriculostomy. The protractor 20 can be aligned with one of the markers 16, 17, or 18 such that angles can be measured between the markers 16, 17, or 18. When the markers 16, 17, 18 are properly positioned by the surgeon, then the frame 12 may be rotated to align the frame 12 with one of the markers 16, 17, 18. [0017] The probes 14 are threadedly received in the frame 12 as is conventional in the art. The probes 14 may be advanced along the axis 19 toward one another and also retracted along the axis 19 by rotation relative to the frame 12. Contact surfaces 36 of the probes 14 are configured to contact an anatomical reference point, such as the external auditory meati, of the patient's head so that the frame 12, markers 16, 17, 18 and the protractor 20 may be fixed but for pivotal movement about the axis 19. The probes 14 may also fix the pivotal motion of the frame 12 so that the frame may not rotate about the axis 19. For example, a small hole may be positioned on the arc 12 to accommodate a locking screw. The locking screw is tightened down when the correct desired angulation of the arc 12 has been obtained, locking the arc in place with respect to the fixed probes 14. In an additional embodiment the EAM probes 14 may have prefixed accommodations, e.g. depressions, to provide easier locking down of the screw. Such a configuration allows a surgeon to use the fixed frame 12 to guide surgical tools during surgery. [0018] FIG. 2 is a lateral view of the localizing device of FIG. 1 donned by a patient. The probes 14 are advanced on opposite sides of a patient's head 50 until the contact surfaces 36 (FIG. 1) of the probes contact a desired reference such as the external auditory meati. When the probes 14 are so positioned, the markers 16, 17, 18 and the protractor 20 are all centered for rotation about an axis normal to the external auditory meati. In this example, the external auditory meati serve as an anatomical reference point for localizing the portion of the brain. The markers 16, 17, 18 can be rotated about the anatomical reference point to align with other anatomical reference points and to define desired angles between the markers. [0019] For example, the anatomical reference marker 16 may align the external auditory meati (centered on probe 14) with the most posterior point on the mandibular angle 21 (angulus mandibulae). The mandibular angle 21, the ipsilateral angle of the mandible when the jaw is closed, is a palpable anatomical reference point on the head (e.g. see FIG. 162: Eduard Pernkopf, Atlas of Topographical and Applied Human Anatomy, Volume I: Head and Neck. 2 .sup.nd Revised Edition. Urban & Schwarzenberg, Baltimore-Munich, 1980). After the anatomical reference marker 16 is aligned along this mandibulomeatal line (MML), the protractor 20 can reference angles with respect to the MML. Optionally, a perpendicular reference marker 17 may be aligned at 90.degree. to the MML to create a perpendicular reference (angle .theta.). The target marker 18 may then be rotated to measure an angle from the perpendicular reference marker 17 (angle .beta.) or the anatomical reference marker 16 (angle .alpha.) to mark a desired plane in which the target ventricle of the brain lies. Alternatively, the markers 16, 17, 18 may be set in a fixed relative relationship so that a predetermined target portion of the ventricle is localized without the protractor 20. In this embodiment, when the anatomical reference marker 16 is aligned with the MML, the target marker 18 aligns with the plane that transversely intersects the target portion of the brain. Continue reading... Full patent description for Localizing device for ventriculostomy Brief Patent Description - Full Patent Description - Patent Application Claims Click on the above for other options relating to this Localizing device for ventriculostomy patent application. ###  How KEYWORD MONITOR works... a FREE service from FreshPatents1. Sign up (takes 30 seconds). 2. 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