Midas rex legend stylus

Seven formalin-fixed cadaveric heads injected with colored neoprene latex (14 sides) were used. Anatomical dissections were performed with the use of microscope (Leica microsystems GmBH), endoscope (4K camera Karl Storz GmbH). For the endoscopic part, 18 ​cm long 4-mm-diameter 0°, 30°, 45° endoscopes were used. Bone resection was performed with a high-speed drill (Midas Rex Legend Stylus, Medtronic). Intra-operative images were recorded and stored with the Karl Storz Aida system. High resolution computed tomography (CT) was performed to obtain the measurements of distances and angles as described below. Measurements of distances and angles between entry points and targets (described below) were obtained with high resolution computed tomography (CT) performed before and after C-shaped craniotomy and dissection.
For documentation and confirmation of anatomical structures as well as defined landmarks, neuro-navigation was used (Stealth Station S7, Medtronic).
Owner of cadavers as well as the patient of the case presentation consented to the publication of their images. The study received approval from our institution institutional review board.

Anatomic dissections were performed at the Laboratory of ICLO Teaching and Research Center (Verona, Italy). Four formalin-fixed cadaveric heads injected with colored neoprene latex (8 sides) were used. Before and after dissection, all specimens underwent a multi-slice helical computed tomography (CT) scan (SIEMENS Somaton GoTop software version VA30A-SP03) with 0.5 mm thick axial spiral sections and a 0° gantry angle. Both endoscopic transorbital and supraorbital approaches were performed using a rigid endoscope of 4 mm diameter and 18 cm length, with 0° and 30° lenses (Karl Storz, Tuttlingen, Germany). The endoscope was connected to a light source through a fiber optic cable (300 W Xenon; Karl Storz) and to an HD camera (Endovision Telecam SL; Karl Storz). Bone resection was performed with a high-speed drill (Midas Rex Legend Stylus, Medtronic). For documentation and confirmation of anatomical structures and defined landmarks, neuro-navigation was used (StealthStation Treon, Medtronic, Jacksonville, FL, USA). Intra-operative images were recorded and stored with the Karl Storz Aida system. Institutional review board approval was not required for this study. The authors state that every effort was made to follow all local and international ethical guidelines and laws that pertain to the use of human cadaveric donors in anatomical research (Iwanaga et al., 2022 (link)).