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  • Skull trephines designed for automatic or semiautomatic cutting of circular sections of the skull (known as cranial perforators). These instruments consist of two coaxial drills, a drive shank that connects to a powered (electric or pneumatic) handpiece, and a built-in clutch mechanism. The inner drill extends slightly beyond the outer drill in such a way that when the inner drill penetrates the inner table of the skull, the clutch mechanism disengages the cutters from the drive shank, preventing penetration or nicking of the membrane that contains the cerebrospinal fluid and protecting the cortex (dura mater). Automatic cranial perforators are used to make holes to alleviate intracranial pressure or to obtain cerebrospinal fluid samples. They are also used to drill perforations that define the border of a cranial bone flap; a side-cut (slot) drill bit is used to complete a beveled cut between adjacent drills completing the bone flap in procedures such as excision of tumors and treatment of cerebral aneurysms. Automated cranial perforators are available as reusable or disposable units; some are designed for use with specific electric and/or pneumatic handpieces.
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