61605 Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural

Name of the Procedure:

Resection or Excision of Neoplastic, Vascular, or Infectious Lesion of Infratemporal Fossa, Parapharyngeal Space, Petrous Apex; Extradural

Summary

This surgical procedure involves the removal of abnormal growths, blood vessel malformations, or infections located in complex and crucial areas at the base of the skull. Specifically, it targets the infratemporal fossa, parapharyngeal space, and petrous apex, all of which are situated near vital nerves and blood vessels.

Purpose

This procedure addresses tumors, vascular anomalies, and infections in difficult-to-reach areas of the head. The goal is to remove these lesions to prevent complications, alleviate symptoms, and improve the patient's quality of life.

Indications

• Presence of benign or malignant tumors in the region.
• Vascular malformations like arteriovenous malformations or aneurysms.
• Persistent or recurrent infections not responsive to other treatments.
• Symptoms such as pain, neurological deficits, or cranial nerve compression.

Preparation

• Fasting for at least 8 hours before surgery.
• Medication adjustments as directed by the physician.
• Preoperative diagnostic tests, including CT scans, MRIs, and angiograms.
• Comprehensive health evaluation and discussion of medical history.

Procedure Description

1. The patient is administered general anesthesia to ensure they are asleep and pain-free during the procedure.
2. Surgeons make an incision and skilfully navigate through or around critical structures to access the lesion.
3. Specialized tools such as microsurgical instruments and navigational systems are used to precisely remove the abnormal tissue without damaging surrounding areas.
4. Once the lesion is excised, the area is carefully inspected, and bleeding is controlled.
5. The incision is closed, and sterile dressings are applied.

Duration

The procedure can take anywhere from 3 to 8 hours, depending on the complexity and location of the lesion.

Setting

Typically performed in a hospital's operating room equipped with advanced surgical and imaging technology.

Personnel

• Neurosurgeon or specialized head and neck surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Bleeding
• Infection
• Damage to surrounding nerves and blood vessels
• Cerebrospinal fluid leak
• Longer-term complications like difficulty swallowing, speech issues, or facial weakness

Benefits

• Effective removal of the lesion
• Relief from symptoms such as pain or neurological deficits
• Potentially life-saving, especially in cases of malignant tumors or large vascular malformations

Recovery

• Initial hospitalization for close monitoring.
• Pain management and antibiotics as prescribed.
• Gradual return to normal activities under the surgeon’s guidance.
• Follow-up appointments to assess healing and any need for additional treatments, such as physical therapy or radiation therapy.

Alternatives

• Observation for slow-growing benign tumors.
• Radiation therapy for certain types of tumors or vascular malformations.
• Less invasive techniques like stereotactic radiosurgery, though these may not be suitable for all lesions.

Patient Experience

Patients may experience pain and swelling initially, managed with medication. Numbness or weakness in parts of the face or head may occur and typically resolves over time. Close follow-up is necessary to ensure proper healing and address any complications that arise.