1 A Hajek-Kofler punch to remove thick bone. The rotating sleeve allows its jaws to be pointed in any direction and for the handle to be in a comfortable position for the operator.
2 A Kerrison punch allows fine controlled removal of small segments of bone and the slight reversed angle of its jaws helps to remove the back of the vomer.
3 A long-shanked drill with a coarse diamond to remove any bone in the roof of the sphenoid bone in a controlled way.
4 A computer-guided system.
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