Skull Base 2011; 21(5): 323-328
DOI: 10.1055/s-0031-1284214
ORIGINAL ARTICLE

© Thieme Medical Publishers

Repositioning of Cranial Bone Flaps Cut with a Diamond-Coated Threadwire Saw: 5-Year Experience with Cosmetic Cranioplasty without Fixation Devices

Satoru Shimizu1 , Koji Kondo1 , Tomoya Yamazaki1 , Kenji Nakayama1 , Isao Yamamoto1 , Kiyotaka Fujii2
  • 1Department of Neurosurgery, Yokohama Stroke and Brain Center, Yokohama, Japan
  • 2Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
21. Juli 2011 (online)

ABSTRACT

Artificial fixation systems for cranial bone flaps have problems related to their materials and designs. We developed an alternative technique for supratentorial craniotomy that employs a diamond-coated threadwire saw (diamond T-saw), originally developed for spinal surgery, and reduces the bone gap for fitted bone flap fixation. The study subjects were 77 adults undergoing elective supratentorial craniotomy. After placing a burr hole at each corner of the craniotomy, we performed osteotomy between adjacent burr holes to approximately one-third of the length of the osteotomy with a craniotome; this leaves a bony bridge at each corner. The diamond T-saw was introduced between adjacent burr holes through the epidural space and a bridge was cut with reciprocating strokes. On closure, the bridge firmly supports the flap and only sutures are needed for fixation. Successful bone flap fixation was obtained in all followed-up cases. There were no technique-related complications such as dural laceration, flap displacement, or resorption. Our method is ideal for bone cuts in cosmetic cranioplasty; it is easy, safe, and inexpensive and avoids the need for flap fixation with artificial devices.

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Satoru ShimizuM.D. 

Department of Neurosurgery, Yokohama Stroke and Brain Center

1-2-1 Takigashira, Isogo-ku, Yokohama 235-0012

eMail: Satoru4756@aol.com