62120 Repair of encephalocele, skull vault, including cranioplasty

Name of the Procedure:

Repair of encephalocele, skull vault, including cranioplasty

Summary

This procedure involves the surgical correction of an encephalocele, which is a rare neural tube defect where brain tissue and membranes protrude through an opening in the skull. The surgeon will repair the skull defect and perform cranioplasty to reconstruct the skull.

Purpose

The primary aim of this procedure is to correct the skull defect caused by the encephalocele, protect the brain, and improve neurological function. Reconstructing the skull can also enhance the cosmetic appearance and structural integrity of the skull.

Indications

Patients with encephalocele, identified through imaging studies or visual inspection at birth, are candidates for this procedure. Symptoms warranting the surgery may include hydrocephalus (fluid accumulation in the brain), neurological deficits, or risk of infection.

Preparation

• Fasting for at least 8 hours prior to the surgery.
• Adjusting or pausing certain medications as instructed by the healthcare provider.
• Preoperative imaging tests like MRI or CT scans to assess the extent of the encephalocele.

Procedure Description

1. Anesthesia: Administering general anesthesia to ensure the patient is unconscious and pain-free.
2. Incision: Making an incision on the scalp to access the skull defect.
3. Repair: Carefully repositioning and securing the protruded brain tissue back into the cranial cavity.
4. Cranioplasty: Reconstructing the skull defect using materials such as bone grafts or synthetic substitutes to restore the skull's shape and function.
5. Closure: Closing the incision with sutures.

Duration

The procedure typically takes several hours, depending on the complexity of the encephalocele.

Setting

This surgery is performed in a hospital operating room, often within a specialized neurosurgical unit.

Personnel

• Neurosurgeon
• Plastic surgeon (for cranioplasty)
• Anesthesiologist
• Surgical nurses and operating room technicians

Risks and Complications

• Infection
• Bleeding
• Cerebrospinal fluid leakage
• Neurological deficits
• Reaction to anesthesia
• Recurrence of the encephalocele

Benefits

• Protection of brain tissue
• Improved neurological function
• Enhanced cosmetic appearance
• Restoration of skull integrity The benefits are often realized shortly after recovery from surgery.

Recovery

• Hospital stay for several days post-surgery for monitoring and initial recovery.
• Pain management with prescribed medications.
• Avoiding strenuous activities for several weeks.
• Follow-up appointments for monitoring healing and evaluating neurological function.

Alternatives

Non-surgical options are limited for encephalocele due to the severity of the condition. Conservative management may include observation and supportive care but is not typically curative. Alternative surgical techniques might include different approaches to cranioplasty materials or methods.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. Post-procedure, the patient may experience pain or discomfort managed through medications. They might temporarily have swelling, bruising, or a feeling of tightness around the surgical site. Regular follow-ups will ensure proper healing and recovery.