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Excision of neurofibroma or neurolemmoma; cutaneous nerve

CPT4 code

Name of the Procedure:

Excision of Neurofibroma or Neurolemmoma; Cutaneous Nerve Common names: Neurofibroma removal, Neurolemmoma excision, Benign nerve tumor removal

Summary

The excision of a neurofibroma or neurolemmoma involves surgically removing a benign tumor from a cutaneous nerve. These growths are non-cancerous but may cause discomfort, pain, or cosmetic concerns.

Purpose

Medical Condition:
  • Neurofibroma
  • Neurolemmoma (Schwannoma)
Goals:
  • Remove the tumor to alleviate pain or discomfort.
  • Restore normal nerve function.
  • Improve cosmetic appearance.

Indications

  • Presence of a palpable lump or mass on the skin.
  • Pain, numbness, or tingling in the area of the tumor.
  • Cosmetic concerns.
  • Growth or changes in the tumor size over time.

Preparation

  • Fasting typically not required unless sedation is used.
  • Medication adjustments may be needed; discuss with your doctor.
  • Pre-procedure imaging studies such as MRI or ultrasound may be conducted to assess the tumor.

Procedure Description

  1. Anesthesia: Local anesthesia is often used to numb the area; sedation may be offered.
  2. Incision: A small incision is made over the site of the tumor.
  3. Excision: The neurofibroma or neurolemmoma is carefully dissected and removed.
  4. Closure: The incision is then closed with sutures or surgical adhesive.
Tools and Equipment:
  • Scalpel
  • Surgical scissors
  • Forceps
  • Suture material

Duration

  • Typically, the procedure takes about 30 minutes to 1 hour, depending on the tumor size and location.

Setting

  • This procedure is usually performed in an outpatient clinic or surgical center.

Personnel

  • Surgeon
  • Surgical nurse
  • Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

  • Infection
  • Bleeding
  • Scarring
  • Nerve damage, though rare, which may cause temporary or permanent numbness/weakness
  • Recurrence of the tumor

Benefits

  • Relief from pain or discomfort.
  • Improved function of the affected nerve.
  • Enhanced cosmetic appearance.
  • Most patients see benefits almost immediately after recovery from surgery.

Recovery

  • Keep the incision site clean and dry.
  • Follow specific wound care instructions provided by your surgeon.
  • Avoid strenuous activities for 1-2 weeks.
  • Typically, a follow-up appointment within one week to assess healing.
  • Full recovery is expected within a few weeks.

Alternatives

  • Monitoring the tumor with regular imaging if symptoms are mild.
  • Medication to manage pain or discomfort.
  • Minimally invasive techniques like laser therapy may be considered.

Patient Experience

  • During the procedure, patients under local anesthesia may feel pressure but should not feel pain.
  • Post-procedure, mild pain or discomfort can be managed with over-the-counter pain relievers.
  • Swelling or bruising around the incision site is common but typically resolves within a few days.

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