See preoperative and postoperative pictures of posterior fossa midline tumour in a child--Craniotomy with Karam chand trephine
Appreciate the craniotomy with Karam Chand trephine having adjustable dura guard. No bone nibbling has been done and entire bone has been replaced. Craniectomy for posterior fossa lesions and burr holes have been misadventures in history of neurosurgery. Infact there is absolutely no indication for burr hole and the very name should be deleted from text books of neurosurgery. Please do not conclude that this is being written to promote my instruments but ponder for a while --Why make a burr hole and tell me one indication. Apart from routine trephine craniotomy I also make bone flap like in meningiomas of bigger size but instead of burr hole I make multiple 1.5 cm trephines with dura guard trephine and nicely dissect dura and then cut the intervening bone with drill or gigli saw or with my special saw and chisel having dura guard. Old conventions are hard to change but we must see a reason in newer development.
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