Trepanation or Complete Removal of the Outer Table of the Calvarium for Granulation Induction: The Erbium:YAG Laser as an Alternative to the Rose Head Burr

BACKGROUND: Large scalp defects devoid of periosteum following tumor excisions are a surgical challenge. In this case, drilling the outer table of the calvarium with a rose head burr is a standard method to induce granulation tissue. OBJECTIVES: We describe an alternative for trepanation or complete removal of the outer table of the calvarium. METHODS: We demonstrate the use of an erbium:yttrium-aluminum-garnet (erbium:YAG) laser for the induction of granulation tissue, compare this technique with the standard procedure and evaluate the benefits and limitations. RESULTS: The erbium:YAG laser is an excellent method for trepanation or complete removal of the outer table of the calvarium and induction of granulation tissue. Conclusion: The use of the laser for trepanation of the calvarium gives results comparable to those of the rose head burr for inducing granulation tissue but has its benefits. Therefore, this method should become a standard alternative to the known procedure.