Craniotomy using image-guided oscillating saw: technical note
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Updated: Aug 9, 2026
A Large Lateral Craniotomy Procedure for Mesoscale Wide-field Optical Imaging of Brain Activity
Published on: May 7, 2017
Paolo Ferroli1, Angelo Franzini, Marcello Marchetti
1Department of Neurosurgery, Istituto Nazionale Neurologico ''C. Besta'', Milan, Italy. pferroli@istituto-besta.it
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.
