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COMPARISON OF TWO CRANIOTOMY TECHNIQUES

Abstract

A craniotomy is the process of removing portions of the skull on a human cadaver in an effort to remove the brain for study. A craniotomy is often completed in undergraduate gross anatomy laboratory by both graduate and undergraduate student dissectors. Generally, this involves preparing the skull by removing skin, connective tissue, and muscle. Then a bone saw is used to carefully remove bone without damaging the underlying tissue. Getting the best specimen usually requires time and the technique used can vary. Research on comparing techniques is sparse. PURPOSE: To qualitatively compare two different craniotomy techniques based on specimen quality, time, and student dissector feedback. METHODS: Four senior undergraduate students, each with roughly 30 hours of dissection experience, were paired into two teams and supervised by an instructor who has performed approximately 14 craniotomies over the past 10 years. Each team completed one to two different craniotomy techniques from the same dissection textbook. One team completed Technique 1 (T1), a circumferential dissection technique. The other completed Technique 2 (T2) that involved cutting two half-circle portions of bone, followed by removal of a third sagittal section of bone. A total of four craniotomies were performed on four separate donors. This allowed for two practice craniotomies for familiarization as well as the two craniotomies used for the qualitative analyses. The techniques were ranked using a 4-point Likert scale on 1) the quality of the brain specimen, 2) the quality of the intact meninges, 3) time required, and 4) the overall ease in following the directions as stated in the book. Student feedback was also collected. RESULTS: Both techniques were successful in yielding a brain specimen that could be used for teaching purposes. However, T1 ranked lower than T 2 on all the 4-point scales. On brain quality, T1 averaged 3 and T2 averaged 4. On meninges quality, T1 averaged 1 and T2 averaged 3. In terms of time, T1 averaged 3 (3 hours) and T2 averaged 4 (2.5 hours). Finally, in terms of ease, T1 averaged 3 and T2 averaged 4. CONCLUSION: Future craniotomies should utilize Technique 2 as it yielded a higher quality brain and meningeal specimens and was both faster and easier for undergraduate dissection student to perform.

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