Safety and feasibility of transitioning from conventional burr-hole craniostomy to endoscope-assisted evacuation for chronic subdural hematoma: A retrospective cohort study.

Sing Soon Sam, Fu-Shan Jaw, Che-Kuang Lin, Tiing Foong Siow, Shyi Chun Yii, Yin-Jen Chang

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5 · Who and what money

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6 authors.

Sing Soon SamDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.ORCID 0000-0002-8250-0193

Fu-Shan JawDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Che-Kuang LinDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Tiing Foong SiowDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Shyi Chun YiiDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Yin-Jen ChangDepartment of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

ObjectiveAlthough endoscope-assisted evacuation for chronic subdural hematoma (cSDH) may reduce recurrence rates, its adoption has been limited by a procedural learning curve that may affect operative efficiency and clinical outcomes. This study compared conventional burr-hole craniostomy with endoscope-assisted evacuation for symptomatic cSDH and evaluated the challenges of institutional implementation.MethodsWe retrospectively reviewed patients with symptomatic cSDH treated between 2023 and 2025. Patients in the treatment group underwent endoscopic-assisted hematoma evacuation, while those in the control group received conventional burr-hole craniostomy. Continuous variables were compared using Student's t-test or Mann-Whitney U test, and categorical variables were analyzed using Fisher's exact or Chi-square tests. Multivariable logistic regression was performed to identify independent predictors of outcomes, with results reported as adjusted odds ratios (aOR) and 95% confidence intervals (CI). Statistical significance was defined as a two-tailed p < 0.05. All analyses were conducted using R software.ResultsA total of 110 patients were included (treatment group,

Indexed as

CraniotomyEndoscopyHematoma, Subdural, ChronicAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment Outcomeburr-hole craniostomychronic subdural hematomaendoscope-assisted surgeryminimally invasive neurosurgeryneuroendoscopy

Identifiers

PMID42186899

DOI10.1177/00368504261456424

PMCPMC13213093

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.