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Trepanning, also known as trepanation, trephination, trephining or making a burr hole (the verb trepan derives from Old French from Medieval Latin trepanum from Greek trúpanon, literally "borer, auger"), [1] [2] is a surgical intervention in which a hole is drilled or scraped into the human skull.
A trephine with a center pin can be seen on the left. Dr. John Clarke trepanning a skull, ca. 1664, in one of the earliest American portraits. Clarke has a trephine in his right hand.
Frontal sinus trephination is a surgical procedure wherein a small opening is made in the floor of the frontal sinus to facilitate drainage of its contents. Drainage of the frontal sinus is done through the floor of frontal sinus above the inner canthus .
Trephination was when a small hole was drilled into a person's skull to let out demons, as that was an earlier belief for mental disorders. Bloodletting is when a certain amount of blood was drained out of a person, due to the belief that chemical imbalances resulted in mental disorders.
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Trephination was a primitive skull surgery used by the Nazca that relieved pressure on the brain from battle wounds or for ritual purposes. It entails the removal of one or more sections of bone from the skull (while the person is still alive). Evidence of trephination has been seen through the analysis of excavated skulls.
The trepanation tool is generally equipped with a clutch which automatically disengages once it touches a softer tissue, thus preventing tears in the dura mater. For larger openings, the craniotome is an instrument that has replaced manually pulled saw wires in craniotomies from the 1980s.
In March 2011, investigators from Australia and several other countries published the results of the DECRA [5] trial in The New England Journal of Medicine.This was a randomized trial comparing decompressive craniectomy to best medical therapy run between 2002 and 2010 to assess the optimal management of patients with medically refractory ICP following diffuse non-penetrating head injury.