Craniotomy using image-guided oscillating saw: technical note

Neurol Res. 2006 Mar;28(2):145-8. doi: 10.1179/016164106X98017.


Objective: To describe a new craniotomic technique that eliminates burr holes and minimizes bone loss along the craniotomic line.

Patients and methods: Fifty burr hole free craniotomies were performed in varied locations using an image-guided micro-oscillating saw. Care was taken to avoid cutting the inner cortical layer. Upon completing the micro-oscillating saw cut the inner table could then be gently fractured along the craniotomic line with a thin bladed osteotome. Simple silk sutures were used to resecure the bone flap.

Results: The craniotomic time required for this procedure ranged from 7 to 24 minutes (mean: 13 minutes). We observed no dural lacerations or signs of brain damage in any of these procedures. The use of image guidance allows a continuous measure of bone thickness along the craniotomic line. In all of the cases we report the cosmetic result was excellent.

Conclusion: This alternative technique of craniotomy can be used in selected cases to achieve excellent cosmetic results which avoid the time and cost of complex reconstruction techniques.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain / pathology
  • Brain / surgery
  • Brain Diseases / diagnostic imaging
  • Brain Diseases / surgery
  • Brain Injuries / prevention & control
  • Child
  • Craniotomy / instrumentation*
  • Craniotomy / methods*
  • Dura Mater / anatomy & histology
  • Dura Mater / surgery
  • Female
  • Humans
  • Intraoperative Complications / prevention & control
  • Male
  • Middle Aged
  • Neuronavigation / instrumentation*
  • Neuronavigation / methods*
  • Skull / anatomy & histology
  • Skull / diagnostic imaging
  • Skull / surgery*
  • Surgical Instruments / standards
  • Surgical Instruments / trends*
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / trends
  • Treatment Outcome