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Drill choice as a modifiable factor in pediatric sEEG safety

Dalmage M, Abdelmageed S, Chiu L, Adeshina O, Poland E, Raskin JS

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026

Abstract

Purpose: Stereoelectroencephalography (sEEG) procedures require drilling serial burr holes for electrode placement. Key drilling characteristics include haptic feedback, ease of use, and time-efficient burr hole creation. Orthopedic drill bits are often repurposed for sEEG. We present a case series highlighting sEEG as an application for a new-to-market neurosurgery-tailored drill.

Methods: We performed a retrospective chart review on patients who underwent sEEG at our institution from 2022-2023. Patients were grouped by type of drill, Phasor® (a disposable battery-operated drill 3.20-mm diameter, 210-mm usable length) or Stryker® (Orthopedic Drill Cordless).

Results: Twelve patients underwent sEEG with the neurosurgery-tailored drill (2 unilateral and 10 bilateral); on average 10.7 ± 1.6 electrodes were placed per patient and mean operative duration was 162.9 ± 49 min. Tactile feel of bony layers and consistent drill time per burr hole (® orthopedic drill (2 unilateral and 3 bilateral); an average of 11 ± 2.9 electrodes were placed per patient, mean operative duration was 176.4 ± 18.9 min. Subjectively, drill time per burr hole was variable and increased in duration between the first and final hole. One patient incurred a skin burn at the drill site which led to wound dehiscence and infection requiring prolonged wound care and antibiotics.

Conclusion: The Phasor® drill offers a lightweight, reliable, consistent, safe and efficient option for sEEG burr hole creation and may…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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