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Craniectomy; with excision of tumor or other bone lesion of skull

CPT4 code

Name of the Procedure:

Craniectomy; with excision of tumor or other bone lesion of skull
Common name: Craniectomy for Skull Tumor/Bone Lesion Removal

Summary

In a craniectomy for the excision of a tumor or bone lesion, part of the skull bone is removed to allow a surgeon to access and remove abnormal growths or lesions on the skull.

Purpose

This procedure is performed to remove tumors or other abnormal growths from the skull. The primary goal is to eliminate the lesion to prevent it from causing neurological damage or other complications, improving patient outcomes and relieving symptoms.

Indications

  • Presence of a skull tumor or bone lesion identified through imaging.
  • Symptoms such as headaches, seizures, vision problems, or neurological deficits.
  • Rapid growth or changes in the lesion that may indicate malignancy.
  • Risk of the lesion affecting brain function.

Preparation

  • Patients may need to undergo blood tests, CT scans, or MRI scans.
  • Fasting for a specific period before the procedure.
  • Adjustment or temporary discontinuation of certain medications, such as blood thinners.

Procedure Description

  1. Anesthesia: General anesthesia is administered to keep the patient unconscious and pain-free.
  2. Incision: A scalp incision is made to expose the skull.
  3. Bone Removal: A surgical drill and other tools are used to remove a section of the skull.
  4. Tumor Excision: The surgeon carefully removes the tumor or bone lesion.
  5. Reconstruction: The removed bone may be replaced or a synthetic material may be used to repair the skull.
  6. Closure: The incision is closed with sutures or staples.

Duration

The procedure typically takes 3 to 6 hours, depending on the complexity and size of the lesion.

Setting

The procedure is performed in a hospital operating room.

Personnel

  • Neurosurgeon
  • Anesthesiologist
  • Surgical Nurses
  • Operating Room Technicians

Risks and Complications

  • Infection
  • Bleeding
  • Blood clots
  • Swelling of the brain
  • Risk of stroke
  • Challenges with wound healing
  • Adverse reactions to anesthesia

Benefits

  • Removal of the tumor or lesion.
  • Relief from symptoms like headaches, seizures, and neurological deficits.
  • Prevention of further complications or neurological damage.
  • Potentially improved quality of life.

Recovery

  • Hospital stay of 1 to 2 weeks for monitoring and recovery.
  • Pain management with medications.
  • Instructions for wound care and signs of infection to watch for.
  • Gradual return to normal activities over several weeks to months.
  • Follow-up appointments to monitor recovery and ensure no recurrence of the tumor/lesion.

Alternatives

  • Radiation Therapy: Non-invasive but may not be suitable for all lesions and can have long-term side effects.
  • Chemotherapy: Used for specific types of tumors, potential systemic side effects.
  • Observation: Regular monitoring with imaging if the lesion is small and not causing symptoms.

Patient Experience

  • During the procedure, patients will be under general anesthesia and will not feel or be aware of the surgery.
  • Post-operatively, patients may experience pain and swelling around the incision site.
  • Pain management will be provided using medications.
  • Patients may feel tired and need support during recovery, with gradual improvement over several weeks.

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