A thermosensitive plate for qualitative measurements of the component temperature of living organisms by means of thermosensitive silicone

Abstract

This invention is in relation to a thermosensitive plate for qualitative measurement of the component temperature of living organisms by means of thermosensitive silicone used in the field of medical surgery.

Description

A THERMOSENSITIVE PLATE FOR QUALITATIVE MEASUREMENTS OF THE COMPONENT TEMPERATURE OF LIVING ORGANISMS BY MEANS OF THERMOSENSITIVE SILICONE FIELD OF THE INVENTION This invention refers to a thermosensitive plate for qualitative measurements of the component temperature of living organisms by means of thermosensitive silicone used in the field of medical surgery. BACKGROUND OF THE INVENTION In current medical treatments for refractory epilepsy that require surgery to control or cure epilepsy, it is essential to be very precise regarding which part of the brain should be removed during surgery to improve control of the crisis, and it is equally important to define which part of the brain it is not necessary to remove during epilepsy surgery. There are currently methods such as electroencephalogram and magnetic resonance imaging, brain tomography, Single Photon Emission Tomography (SPECT), magnetoencephalogram, and the methods used during epilepsy surgery to define the epileptogenic zones are electrocorticography and stereoelectroencephalography. Some of the aforementioned methods are invasive and can affect other areas of the patient's brain during surgery. This invention provides a thermosensitive plate that allows qualitative brain temperature measurements to be taken during surgery using a thermosensitive silicone that changes color according to the temperature to which it is exposed, which will allow the neurosurgeon to visually identify different cerebral cortical temperature patterns. This thermosensitive plate may also be used in other areas of medicine, both surgical and non- surgical, in which it is wished to observe the different temperature patterns of the surfaces with which it is in contact, and in non-medical areas. The same device described above also has incorporated electrodes to simultaneously perform a bimodal record that includes the electrocorticography and the qualitative thermography by means of the change in color of the thermosensitive silicone. The same device described above also has materials incorporated to be registered and followed by navigation systems used in surgery. DETAILED DESCRIPTION OF THE INVENTION BRIEF DESCRIPTION OF THE FIGURES Figure 1 illustrates the parts of the thermosensitive plate, showing the basic version of the thermosensitive plate. Figure 2 illustrates a thermosensitive / thermochromic plate with incorporated electrodes to obtain bimodal information (qualitative temperature and electrical activity of the organ or tissue). Figure 3 illustrates a translucent or thermosensitive / thermochromic plate that is compatible with navigation systems. Figure 4 is a photo of case 1. Figure 5 is a photo of case 2. Figure 6 is a photo of case 3. Figure 7 is a photo of case 4. Figure 8 is a photo of case 5. Figure 9 is a photo of case 6. Figure 10 is a photo of case 7. Figure 11 is a photo of case 8. Figure 12 is a photo of case 9. Figure 13 is a photo of case 10. Figure 14 is a photo of case 11. Figure 15 is a photo of case 12. Figure 16 is a photo of case 13. Figure 17 illustrates a dispersion graph between "Irritative Zone Temperature" and "Maximal Brain Temperature." Figure 18 illustrates a trivariate histogram between Age, Age of Onset, and Meningeal Temperature. Figure 19 illustrates a trivariate analysis graph between Age, Start Age, and Delta T. Figure 20 illustrates a graph showing the difference of medians between Registered Temperatures. Figure 21 illustrates a graph that shows the difference of medians between the Age Proportion / Time with Epilepsy. DETAILED DESCRIPTION OF THE INVENTION We have discovered that the epileptogenic zones are colder than the rest of the brain, as their metabolism is different. There is currently not a thermosensitive plate specifically designed to identify the thermogenic metabolic behavior of the brain during neurosurgical procedures. The thermosensitive plate of this invention could be used in different neurosurgical procedures, such as: epilepsy surgery, vascular neurosurgery, and oncological neurosurgery, among others, and in general surgery to monitor the temperature of organs during transplants, during cardiac bypass surgery, oncological surgery, etc.; furthermore, it may also be used in fields outside of medicine. As shown in Figures 1-3, this invention comprises a thermosensitive silicone plate (1) that responds to the different temperatures to which it is exposed, exhibiting color changes within a few seconds. The basic plate may be phosphorescent, as well as thermosensitive and phosphorescent. The thermosensitive plate may be made of flexible and non-adhesive polymers, one of which may be silicone. This raw material is combined with a colorant, commonly in powder form, but it may be made of any presentation that can be mixed with the base that will form the plate, and once mixed, a catalyst is added and it is poured into a mold. The speed of plate response and the color change contrast once it has come into contact with the thermogenic surface, depends on the quantity of the colorant and the thickness of the plate. More specifically, the chemical components of the thermosensitive plate are "RTV" (room temperature vulcanized) type liquid silicone, to which 0.1 to 30% (range not limited) of the powdered thermochromic thermosensitive colorant is added, which responds with thermal changes within the range of the temperature of the live organism on which it will be placed, and once these two initial components have been mixed homogeneously, 3% of the catalyst is added, which is calculated in relation to the quantity of silicone used. It is then mixed homogeneously and poured into the mold, which may be in any shape, but preferably flat so that the thermosensitive / thermochromic silicone has the largest surface of contact with the target organ or tissue. The thinner the transfer / thickness surface, the more quickly the thermosensitive / thermochromic silicone will respond and with better spatial resolution. In the preferred embodiment of the invention, the thickness range includes, but is not limited to, 1 to 5 mm. Once the drying process at ambient temperature has finished over a maximum period of 48 hours, it may be removed from the mold and cut to the desired size to cover the organ or tissue with which it will be in contact. The thermosensitive plate changes color within a range that can be easily seen by the naked eye, without requiring any type of special light or filter. Normally colors are chosen that contrast when they change color: white / black, purple / pink, yellow / green. The speed of response depends in large part on the amount of colorant that is incorporated into the base plate, and the thickness of the plate. In the preferred embodiment of the invention, although not solely in the preferred embodiment, when the thermosensitive plate comes into contact with the target surface, organ, or tissue, the thermosensitive / thermochromic silicone will change color in a few seconds (depending on the thickness and the quality of the colorant that is included in the mixture; the more colorant there is (without saturating the mixture) and the thinner the plate, the response will have better spatial distribution and will occur in a shorter period of time). Preferably two colors will be chosen (although it is not limited to being two-color) that easily show contrast to the naked eye (including, but not limited to: purple to Mexican pink) as shown in the images. In living beings, higher metabolism usually generates higher temperatures, and vice versa, thus the thermosensitive / thermochromic silicone plate may have several patterns, depending on the temperature to which it is exposed. The thermosensitive / thermochromic plate (1) may be applied directly to the surface of the target tissue or organ to create functional maps, such as over a cerebral cut to identify the zones of metabolic activation of eloquent areas or areas with different metabolism, such as, for example, epileptogenic zones and the start of ictal zones due to their different metabolism. It may also be used to identify neoplastic or infectious lesions on any organ, without the need to use contrast dyes or media. This same thermosensitive / thermochromic plate (1) may have localizers for the navigation systems and / or electrodes for bimodal registration. The thermosensitive silicone plate (1) has incorporated electrodes (5) to simultaneously perform electrocorticography, and for qualitative determination of the cerebral temperature. More specifically, the thermosensitive plate for qualitative measurements of the component temperature of organisms of this invention comprises a thermosensitive silicone plate (1) with a temperature irradiation surface (2), a conduction plane (3), and a temperature transfer surface (4); and at least one electrode to register electrical activity (5) placed on the temperature irradiation surface (2). The device of this invention also comprises compatible material locators (7) to be detected by navigation systems placed on the temperature irradiation surface (2), with the goal of the navigation system being able to make corrections in rotation, movement, and deformation of the target tissue or organ. With the technical characteristics of this invention, the observer will be able to visually identify different temperature patterns with which the device is in contact. The silicone may also be transparent, with color, or it may be thermochromic, and it may also have "fiducials" incorporated into it, which are markers that can be recognized by the different navigation systems that will allow the navigation systems to make adjustments through anatomic changes caused by surgical manipulation of the tissue or organ that is manipulated, or by displacement by gravity, movement, rotation, or anesthetic effect, among others, thus increasing precision during navigation-guided surgeries. The thermosensitive / thermochromic silicone may also be phosphorescent. With the thermosensitive / thermochromic silicone plate of the thermosensitive plate of this invention, functional maps can be made of the different components and organs of living beings, including functional cerebral mapping. The thermosensitive / thermochromic silicone plate of the thermosensitive plate may be flexible and moldable, and it may be placed directly on the surface that will be evaluated, or it may be isolated by a thin layer of material to make it biocompatible, if so required. Furthermore, with the thermosensitive plate of this invention, the blood flow can be detected by its temperature gradient. The thermosensitive plate of this invention does not require electric parts, in its version to be used as the base for electrocorticography grids. The difference with the current electrocorticography grids is that in addition to the electrodes to register the electrical activity of the cerebral cortex, it may have "fiducials" to be detected by navigation systems, and it may be thermosensitive / thermochromic to take BIMODAL measurements of the activity of the organ being evaluated, specifically the nervous system, which includes the qualitative evaluation of the temperature and the electrical activity, SIMULTANEOUSLY. This invention has a method of application that consists of the steps of: a) Keeping the thermosensitive plate cold. b) Eliminating any substance that might interfere in the plate's contact with the target surface. c) Leaving the plate in contact with the target surface, without moving it or modifying its temperature with solutions or exposure to warm light, for example. d) Observing the visual response with the naked eye, which will depend on the temperature and adequate contact of the thermosensitive plate with the target surface. e) Removing the thermosensitive plate. f) Cooling the plate to a temperature that is lower than body temperature, ideally using a cold sterile saline solution. g) Repeating the process as required. An example of an embodiment of the invention that shows that the invention can be used is found in the following epilepsy surgery tests to define the epileptogenic zones, which consists of temperature measurement tables that were created in twelve epilepsy cases, where it can be clearly seen that the zones responsible for the epilepsy are between 2 and 7°C colder than the rest of the brain. That is to say, the temperature varies according to the region. The cortex is colder than the basal ganglia, and the basal ganglia are colder than the brain stem in resting state, and when an eloquent area of the brain is used, this increases temperature, as shown in the videos of the patient on whom I operated when he was awake. These tables show the measurements from each case, with each table showing a range of colors that clearly illustrates how the irritative activity zone in patients with epilepsy is colder (blue), and around this colder zone there is a radial heating pattern towards the healthy brain tissue. It is from that assessment that a silicone was designed, so that instead of all of these measurements we can qualitatively identify the coldest zone with the change in color of the silicone (purple is cold, pink is hot). Tests [Image disponible dans le document PDF, Image available in the PDF document] [Image disponible dans le document PDF, Image available in the PDF document] [Image disponible dans le document PDF, Image available in the PDF document] [Image disponible dans le document PDF, Image available in the PDF document] Results Twelve patients who met the study's inclusion criteria were studied, and of these patients, three were male (25%) and nine were female (75%). The average age was <semantics>32.5±16.6596<annotation encoding="application / x-tex">32.5 \pm 16.6596< / annotation>< / semantics> years, the asymmetry index value was 0.795, therefore the distribution is skewed to the right, with a 5 Kurtosis value of 0.047 being the flat distribution due to the range and size of the population. Note that the average and standard deviation of the temperatures recorded in the Irritative Zone Temperature and the Maximal Brain Temperature are almost equal, therefore the size of the existing sample is valid for this study (See Table 1). Table 1. Descriptive Statistics [Image disponible dans le document PDF, Image available in the PDF document] Note that the descriptive statistics show the average and standard deviation of the Irritative Zone Temperature and Maximal Brain Temperature trend towards equality. The averages of the recorded temperatures were compared, and a significant difference was found between the Irritative Zone Temperature and the Maximal Brain Temperature with <semantics>α≤0.0001<annotation encoding="application / x-tex">\alpha \leq 0.0001< / annotation>< / semantics>, and between the Meningeal Temperature and Irritative Zone Temperature with <semantics>α≤0.004<annotation encoding="application / x-tex">\alpha \leq 0.004< / annotation>< / semantics> (see Graph 1). When creating the dispersion graph, a correlation was found (being greater in the interval <semantics>300≤x≤400<annotation encoding="application / x-tex">300 \le x \le 400< / annotation>< / semantics>) between the variables used, therefore the Pearson correlation coefficient between these two variables was calculated finding that r=0.596, thus by increasing the temperature in the Irritative Zone Temperature, it is also increased in the Maximal Brain Temperature (see Graph 2). Note that in addition to the correlation that exists between these two variables, the difference between their medians is highly significant. In Figure 16, referring to the graphs of recorded Temperature Errors, it was found that the averages and dispersions where the values with the lowest recorded temperatures were in the Irritative Zone. In Figure 17, referring to the dispersion between the Irritative Zone Temperature and the Maximal Brain Temperature, it is seen that when the temperature in the Irritative Zone is increased, it increases the Maximal Brain Temperature. A trivariate graph was created in order to analyze the behavior between Age, Meningeal Temperature, and Age of Onset, where two trends are seen based on this analysis: when age increases, the Meningeal Temperature increases in the range of 13-28 years, and likewise it is seen that in the range of 22-56 years, when age increases the Meningeal Temperature decreases (see Graph 3). In Figure 18, referring to the trivariate histogram between Age, Age of Onset, and Meningeal Temperature, it is seen that temperature tends to stabilize at higher ages. As can be seen in Figure 19, a trivariate graph was created using Age, Age of Onset, and Delta T, in order to evaluate the behavior between these three variables. It was found that by increasing the age of the patients, the value of Delta decreases, noting that the Age of Onset does not influence this trend, and when the age of patients increases the value of Delta decreases. In order to evaluate the behavior of all temperatures recorded by age and patient, a box plot was created in order to compare the medians based on the second and third quartiles, where it is seen that in the interval <semantics>(26≤x≤56)<annotation encoding="application / x-tex">(26 \le x \le 56)< / annotation>< / semantics>, the value of the medians decreases with respect to age, as shown in Figure 20, where it is seen that as of 26 years of age, the medians of temperature registered decreases. In order to evaluate a possible association between age and time with epilepsy, the proportion was calculated (age / time of epilepsy) and box plots were created with all temperatures recorded to analyze the behavior of the medians based on the second and third quartiles, where it was found that of the proportion in the interval <semantics>(1(U)≤x≤2.35(D35))<annotation encoding="application / x-tex">(1(U) \le x \le 2.35(D35))< / annotation>< / semantics> the trend is growing with an angle tending towards 45°, otherwise in the interval <semantics>(2.44(D44)≤x≤33)<annotation encoding="application / x-tex">(2.44(D44) \le x \le 33)< / annotation>< / semantics> the trend is growing with an angle of inclination tending towards 90°, therefore there is a relationship and trend in this proportion, as shown in Figure 21, where the difference can be seen in the trends in the medians of the proportions (U-D35) and (D44-33). Another test was run during another surgery, in which a bimodal measurement was taken in which electrocorticography and cerebral temperature were registered simultaneously, finding the points of maximum abnormal electrical activity by electrocorticography, which were electrodes 7 and 11, and subsequently the purple-colored thermosensitive plate was placed to determine if in positions 7 and 11 the heat is dissipated and the purple-colored thermosensitive plate turns the color pink in the zone of normal electrical activity, and it remains purple in the zone of equal abnormal electrical activity. That is, it was seen that when the thermosensitive silicone plate (1) was placed in the zone responsible for the epilepsy it remained cold (purple). In that patient it corresponds with the abnormal electrical activity registered with electrodes (electrocorticography) during the surgery, while the rest of the silicone heated up quickly and took on a brilliant pink color in the zone where the electrical activity is normal.

Claims

1. A thermosensitive plate for qualitative measurements of brain temperature in surgeries, comprising: a thermosensitive silicone plate (1) comprising: a temperature transfer surface (4) configured to be placed in contact with exposed brain tissue; a temperature irradiation surface (2) opposite to the temperature transfer surface (4); and, a conduction plane (3) disposed between the temperature transfer surface (4) and the temperature irradiation surface (2); wherein the thermosensitive plate is comprised of: liquid silicone;2. The thermosensitive plate for qualitative measurements of brain temperature in surgeries according to claim 1, further comprising one or more locators of compatible material (7) placed on the temperature irradiation surface (2) for detection by navigation systems.

3. The thermosensitive plate for qualitative measurements of brain temperature in surgeries according to claim 1, further comprising at least one electrode (5) placed on the temperature irradiation surface (2) to register electrical activity.

4. A method for preparing a thermosensitive plate for qualitative measurements of brain temperature in surgeries according to claim 1, comprising the steps of: adding liquid silicone in a recipient; adding 0.1 to 30% of a thermosensitive / thermochromic colorant in powder form, the colorant being responsive to temperature changes within a temperature range of an exposed brain tissue on which it will be placed; mixing the liquid silicone and the thermosensitive / thermochromic colorant until a homogeneous mixture is obtained; adding a catalyst in a quantity of 3% and mixing homogeneously; pouring the homogeneous mixture into a mold to form a flat plate with a thickness of 1 mm to 5 mm; drying the plate at ambient temperature for up to 48 hours to form the thermosensitive plate; removing the thermosensitive plate from the mold; and, cutting the thermosensitive plate to a predetermined size to cover the exposed brain tissue.