Types of Craniotomy Surgery
Listed below are the 5 different procedures of performing a craniotomy surgery:
- Extended Bifrontal Craniotomy: This procedure is performed to operate meningiomas, esthesioneuroblastomas, malignant skull base tumors and tumors that cannot be removed by a minimally invasive approach. In this procedure the frontal bone of the skull is cut temporarily so that the tumor can be removed without any manipulation of the brain.
- Supra-Orbital Craniotomy:Also known as the “eyebrow” craniotomy, the supra orbital craniotomy is a minimally invasive procedure in which small incisions are made within the eyebrow to remove pituitary tumors or tumors that are located in front of the brain. This technique is performed when the tumor is too large for an endonasal endoscopic surgery.
- Retro Sigmoid Craniotomy: This is also a minimally invasive surgical approach to remove tumors and is also known as “keyhole craniotomy”. A small incision behind the ear gives the surgeon access to the cerebellum and brainstem through which tumors like acoustic neuromas, meningiomas and skull base tumors are removed.
- Orbitozygomatic Craniotomy: This procedure is performed to remove difficult tumors and treat aneurysms. It is performed by temporarily removing the bone that forms the contour of the orbit and cheek. Craniopharyngiomas, pituitary tumors and meningiomas are treated with this method.
- Translabyrinthine Craniotomy: In this procedure of craniotomy, the incision is made just behind the ear. Thereby the mastoid bone and some of the inner ear bone is removed to extract the tumor without causing any harm to the brain. Acoustic neuroma is treated in this surgical method although its only disadvantage is loss of hearing.
When is a craniotomy performed?
A craniotomy is performed to treat/remove the following:
Tear in the dura mater
Damaged or swollen portions of the brain
Implanting neurostimulator (or brain pacemaker) to treat Parkinson’s Disease
Diagnosis Before Craniotomy Surgery/Treatment
Diagnosis for Craniotomy includes the following tests:
A chest X-ray
Procedure of Craniotomy Surgery
Before performing a craniotomy surgery, several neurology tests are performed to locate the problem in the patient’s brain so that the bone flap can be cut with exact precision, the neurological problem can be diagnosed and the size of the tumor can be estimated.
During the Craniotomy Procedure
Patient will be positioned on the operating table in a manner that provides the best access to the side of the brain to be operated on.
His/her head will be shaved and the skin over the surgical site will be cleansed with an antiseptic solution.
An incision may be made from behind the hairline in front of the ear and the nape of the neck, or in another location depending on the location of the problem.
The scalp will be pulled up and clipped to control bleeding while providing access to the brain.
A medical drill will be used to make burr holes in the skull.
The bone will be cut carefully with a special saw and the bone flap will be removed and saved.
The dura mater (the thick outer covering of the brain directly underneath the bone) will be separated from the bone and carefully cut open to expose the brain.
After the surgeon has extracted the tumor from the targeted location or implanted the neurostimulator (depending on the patient’s case) he/shewill suture (sew) the layers of tissue together. The bone flap will be reattached using plates, sutures, or wires.
The skin incision (scalp) will be closed with sutures or surgical staples. A sterile bandage or dressing will be applied over the incision.
After the Craniotomy procedure
The patient will be kept under observation in the recovery room.
After his/her blood pressure, pulse and breathing are stable and the patient is alert, he/she will be taken to the ICU.
The brain function of the patient is thoroughly checked by the medical staff so as to make sure that his/her body systems are working properly.
The patient is then sent to a rehabilitation facility so that he/she can regain his/her strength.
A craniotomy generally requires a hospital stay of 5 to 7 days.
Factors Affecting Cost of Craniotomy Surgery in India
Following are the factors which will affect the treatment cost:
The hospital the patient is opting for.
Room –Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service).
Operating room, ICU
Fee for the team of doctors (Surgeons, Anesthetist, Physiotherapist, Dietician).
Standard test and diagnostic procedures
Cost of the follow –up care which is required after the procedure.