Craniotome

Craniotome is a surgical instrument used in craniotomy to cut skull bone and create a bone flap for intracranial access. Modern craniotomes are handheld devices that use a rapidly moving blade—either oscillating or rotating—and are designed to cut bone with controlled depth. They are typically powered by electric motors or pneumatics and accept disposable or reusable blades. A protective guard and depth limiter help prevent unintended injury to underlying tissues.

In a craniotomy, the surgeon outlines the skull with burr holes or a continuous groove, then uses the craniotome to complete the bone cuts along planned lines. The intact bone flap is lifted, exposing the dura and brain; after the procedure, the flap is replaced and secured with plates, screws, or sutures.

Historically, craniotomies were performed with trephines, Gigli wires, or manual saws. The introduction of powered oscillating and reciprocating craniotomes in the 20th century improved precision, speed, and safety. Today’s devices emphasize irrigation, suction, and blade management to minimize heat and debris.

Common risks include dural injury, brain contusion, thermal damage, bone fragmentation, and improper flap fixation. Proper technique, visualization, and instrument maintenance reduce these risks.

Craniotomes are part of the broader family of neurosurgical bone-cutting tools, alongside drills and other saws used to access intracranial structures.