Editing Trepanning (section)

=== Modern medical practices ===
The prefrontal leucotomy, a precursor to [[lobotomy]], was performed by cutting a [[trephine]] hole into the skull, inserting an instrument, and destroying parts of the brain.<ref name=Moniz1937>{{cite journal |last=Moniz |first=Egas |title=Prefrontal Leucotomy in the Treatment of Mental Disorders |date=1937 |journal=American Journal of Psychiatry |volume=93 |issue=6 |pages=1379–85 |issn=0002-953X |doi=10.1176/ajp.93.6.1379}}</ref> This was later made unnecessary by the development of the [[Lobotomy#Transorbital lobotomy|orbital transit lobotomy]] where a spike was inserted through the eye-sockets.

Trepanation is a treatment used for [[epidural hematoma|epidural]] and [[subdural hematoma]]s, and surgical access for certain other neurosurgical procedures, such as intracranial pressure monitoring. Modern surgeons generally use the term ''[[craniotomy]]'' for this procedure. Unlike in folk practices, a craniotomy must be performed only after diagnostic imaging (like [[CT scan|computed tomography]] and [[magnetic resonance imaging]]) has pinpointed the issue within the skull; preoperative imaging allows for accurate examination and evaluation. Unlike in trepanation, the removed piece of skull (called a bone flap) is typically replaced as soon as possible, where it can [[bone healing|heal]]. Trepanation instruments, nowadays being replaced with [[cranial drill]]s, are now available with diamond-coated rims, which are less traumatic than the classical trephines with sharp teeth. They are smooth to soft tissues and cut only bone.<ref name="TrepanationJournal">{{cite journal |last1=Mondorf |first1=Y. |last2=Abu-Owaimer |first2=M.|last3=Gaab |first3=M.R. |last4=Oertel |first4=J.M. | date=December 2009 |title=Chronic subdural hematoma – craniotomy versus burr hole trepanation.|journal= [[British Journal of Neurosurgery]]|volume=23 |issue=6 |pages= 612–16|doi=10.3109/02688690903370297|pmid=19922275 |s2cid=41293769 }}</ref> Additionally, the specially designed drills come with a safety feature that prevents the drill from penetrating into the brain tissue (through the dura mater). Along with antisepsis and prophylaxis of infection, modern neurosurgery is a common procedure for many reasons other than head trauma.

In documented cases of trepanning done in Africa and Oceania during the 20th century, patient survival rate was seen to be approximately 90%.<ref name=":4" />