title: Small size craniotomy in endoscopic procedures: Technique and advantages.
abstract: BACKGROUND
  Endoscopic procedure has been known as the method of choice for treatment of hydrocephalus with 8.5% complication rate. It seems that good dural closure, reconstructing bone defect and perfect pericranium suturing can decrease the wound complications. Here, we describe the method of minicraniotomy instead of the burr hole in the endoscopic procedure.
  
  
  METHODS
  A case-control study regarding the cranial opening for endoscopic surgery was done in 45 patients of <12 months age; 15 patients in case group for minicraniotomy and 30 infants as control group for burr hole. They were followed at least 1-month for complications including cerebrospinal fluid collection, wound dehiscence, wound infection, and meningitis.
  
  
  RESULTS
  Patients were between 1 and 11 months. Hydrocephalus (73%) was the most common etiology for endoscopic surgery in this series, followed by the arachnoid cyst (20%). Two patients in the case group and eight in control group developed complications. Meningitis was found in one infant in the control group. Despite less complications in the case group the difference between two cohorts was not statistically significant.
  
  
  CONCLUSIONS
  Minicraniotomy with providing more space in comparison to burr hole makes dural closure possible. It provides a small bone flap that can be replaced inside the bone defect. In spite of nonsignificant statistical difference between two groups regarding complication rate, we found less wound complications with minicraniotomy. Therefore, we advise this technique for the endoscopic procedure and propose minicraniotomy even in the older population to provide better dural opening, watertight dural closure and reconstructing the bone defect.
authors: Department of Neurosurgery, Shariati Hospital, Tehran, Iran.
authors: Mahdi
authors: M
authors: Arjipour
authors: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Sara
authors: S
authors: Hanaei
authors: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Zohreh
authors: Z
authors: Habibi
authors: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Arash
authors: A
authors: Esmaeili
authors: Department of Neurosurgery, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Farideh
authors: F
authors: Nejat
authors: Department of Neurosurgery, Hackensack University Medical Center, New Jersey, USA.
authors: Mostafa
authors: M
authors: El Khashab
keywords: Burr hole; complication; endoscopic surgery; minicraniotomy