Oper Neurosurg (Hagerstown). 2017 Jun 1;13(3):324-328. doi: 10.1093/ons/opw043.
It can be difficult to make complete burr holes using a perforator with automatic releasing systems in cases of a soft diploe or thick calvarial bone.
To demonstrate the utility of a flipped "bone pad" (BP) in recovery of penetration failure when using an automatic releasing perforator.
For craniotomy or ventricular drainage, the first step is to make 1 or more burr holes using a craniotome. Neurosurgeons sometimes incompletely penetrate the skull using the latest tools. As a countermeasure for such cases, we have developed a simple and practical method. When making a perforation using a high-speed perforator, a round bone piece we call the BP is formed just above the dura. We pulled the BP from a completed burr hole, and placed the reversed BP in position at the bottom of the incompletely perforated burr hole. The BP acted as a new hard surface, preventing the automatic releasing system from activating, and allowed the burr hole to be completed by the craniotome without the need for additional tools.
With this technique, we have successfully completed 6 out of 7 imperfectly perforated burr holes using a perforator with an automatic releasing system. There were no technique-related complications, such as plunging or dural laceration.
The method has the advantage that the BP can be obtained without drilling an additional burr hole, and can be completed without the need for increasing cost, time, or instrument usage.
在使用具有自动释放系统的穿孔器的情况下，对于软脑膜或厚颅骨，很难制作完整的骨孔。
展示在使用自动释放穿孔器时，翻转的“骨垫”（BP）在恢复穿透失败时的实用性。
对于开颅术或脑室引流，第一步是使用颅骨切开术制作 1 个或多个骨孔。神经外科医生有时会使用最新的工具不完全穿透颅骨。针对这种情况，我们开发了一种简单实用的方法。当使用高速穿孔器进行穿孔时，我们会在硬脑膜上方形成一个圆形的骨片，我们称之为 BP。我们从已完成的骨孔中拔出 BP，并将反转的 BP 放置在未完全穿孔的骨孔底部。BP 充当了新的硬表面，防止自动释放系统激活，并允许颅骨切开术完成骨孔的穿孔，而无需额外的工具。
使用这种技术，我们成功地使用具有自动释放系统的穿孔器完成了 7 个不完全穿孔骨孔中的 6 个。没有与技术相关的并发症，如下沉或硬脑膜撕裂。
该方法的优点是无需钻额外的骨孔即可获得 BP，并且可以在不增加成本、时间或仪器使用的情况下完成。
