Reinges M H, Rübben A, Spetzger U, Bertalanffy H, Gilsbach J M
Department of Neurosurgery, Technical University (RWTH) Aachen, Germany.
Surg Neurol. 1998 Sep;50(3):226-9; discussion 229-30. doi: 10.1016/s0090-3019(97)00456-4.
Craniotomy with a mechanical twist drill is a standard, minimally invasive procedure in neurosurgery, widely used for the drainage of chronic subdural hematomas and the placement of ventricular drains. Nevertheless, the use of a standard twist drill trephine bears the risk of causing cerebral lesions.
A commercially available mechanical twist drill system has been modified by a special self-controlling drill and a pre-adjustable distance holder that limits intracerebral penetration. After initial cadaver testing, the modified trephine has been used for 65 trephinations in patients (37 chronic subdural hematomas, 21 external ventricular drains, 6 frontal hygromas, 1 tumor cyst).
There were no complications related to the modified trephine; cerebral lesions caused by drilling too deeply or by uncontrolled penetration were safely prevented. In our series no procedure related infections occurred, and the drilling time was reduced significantly.
The described modified mechanical twist drill enables fast, easy, and safe craniotomy without jeopardizing the advantages of a mechanical twist drill. Therefore, it can be recommended particularly for difficult emergency conditions.
使用机械麻花钻进行开颅手术是神经外科的一种标准微创手术，广泛用于慢性硬膜下血肿引流和脑室引流管置入。然而，使用标准麻花钻环钻存在导致脑损伤的风险。
一种市售的机械麻花钻系统已通过特殊的自控钻头和限制脑内穿透深度的预调距固定器进行了改进。在最初的尸体测试后，改进后的环钻已用于65例患者的环钻术（37例慢性硬膜下血肿、21例脑室引流、6例额叶 hygromas、1例肿瘤囊肿）。
未发生与改进后的环钻相关的并发症；安全地防止了因钻孔过深或穿透失控导致的脑损伤。在我们的系列研究中，未发生与手术相关的感染，且钻孔时间显著缩短。
所述改进的机械麻花钻能够实现快速、简便且安全的开颅手术，同时不影响机械麻花钻的优点。因此，特别推荐用于困难的紧急情况。
