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  4. Design Considerations for Robotic, MRI-Guided, Trans-Foramen Ovale Access to the Brain

Design Considerations for Robotic, MRI-Guided, Trans-Foramen Ovale Access to the Brain

AUTHORS

Grillo Abby M. , Peters John E. , Garrow Sarah J. , Ball Tyler , Naftel Robert , Englot Dario J. , Neimat Joseph , Grissom William A. , Barth Eric J. , Webster Robert J. . SPIE Medical Imaging, 2023.

ABSTRACT

This paper advances a new paradigm of minimally invasive neurosurgical interventions through skull foramina, which promise to improve patient outcomes by reducing postoperative pain and recovery times, and perhaps even complication rates. The foramen ovale, a small opening in the base of the skull, is currently used to insert recording electrodes into the brain for diagnosing epilepsy and as a pathway for ablating the trigeminal nerve for facial pain. An MRI-compatible robotic platform to position neurosurgical tools along a prescribed trajectory through the foramen ovale can enable access to deep brain targets for diagnosis or intervention. In this paper, we describe design goals and constraints, determined both heuristically and empirically, for such a robotic system. These include the space available within the scanner around the patient, the set of possible needle angles of approach to the foramen ovale, patient positioning options within the scanner, and the force needed to tilt the needle to desired angles. These design considerations can be used to inform future work on the design of MRI-conditional robots to access the brain through the foramen ovale.

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