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Preoperative identification of the initial burr hole site in retrosigmoid craniotomies: A teaching and technical note
Author(s) -
Zhou Chuan,
Evins Alexander I.,
Boschi Andrea,
Tang Yinda,
Li Shiting,
Przepiorka Lukasz,
Sadhwani Shaan,
Stieg Philip E.,
Xu Tao,
Bernardo Antonio
Publication year - 2019
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1987
Subject(s) - calipers , craniotomy , cadaveric spasm , medicine , neuronavigation , surgery , computer science , mathematics , resection , geometry
Abstract Background When fashioning a retrosigmoid craniotomy, precise placement of the initial burr hole is crucial to avoid iatrogenic sinusal injury and to facilitate a corridor that allows for minimal cerebellar retraction. Methods 3D CT reconstructions of 16 cadaveric sides were used to identify and measure three discrete anatomical points. These three points and distances between them were plotted onto the surface of the skull using a digital caliper to identify the optimal burr hole location. This technique was subsequently applied in 20 clinical cases. Results Optimal burr hole placement was achieved in 87.5% of specimens and, with minor refinement, 100% of clinical cases with no significant increase in operative time. Preoperative planning took an average of 10 minutes. Conclusion This technique for localizing the location of the initial retrosigmoid burr hole is a simple, safe, reliable, rapid, and inexpensive solution for surgeons who do not have regular access to neuronavigation.