Craniotomy is a surgical procedure in which the part of the skull bone is removed for the access of brain tissue. Some special types of surgical instruments are used to remove the bone in the form of flap which is also known as bone flap. The bone flap of the skull is removed for the surgery of the brain and then it is replaced after the surgical procedure has been done. Craniotomy surgical procedure is often performed with the use of advanced technology of computer imaging that allows the surgeon to reach the target location of a brain during surgery. The advanced technology allows the surgeon to see the tumor from 3 sides and allows the precision of removal of the tumor. In this way, the surgeon destroys the tumor cells and limits the damage to the healthy tissue in the surrounding area. Craniotomy procedure is performed for the purpose of treatment of certain diseases like tumors in the brain and also for the diagnostic process like biopsy test to check any presence of the cancer cells. Craniotomy surgical procedure is highly risky as it has some risk factors and complications associated with it. It is highly recommended to prevent these complications before they occur because the brain is a sensitive part of the human body and these complications can cause permanent and irreversible damage.
There are many types of craniotomy. Some of these are:
In this type of craniotomy surgical procedure, a large portion of the frontal bone is removed to access the brain. It provides a clear vision to access the frontal lobes which is the area of the brain that is responsible for the functions such as decision-making, personality, and movement of the body. It is commonly used for the treatment of large or complex brain tumors and other conditions that require extensive access to the brain regions in the front.
This is a less invasive approach that involves making a small incision above the eyebrow to access the brain. It is a specialized type of keyhole craniotomy used to treat conditions in the anterior and middle part of the brain, such as certain brain tumors or aneurysms. The procedure is performed to minimize damage to surrounding tissues and reduce the recovery time as compared to traditional craniotomies.
This is another minimally invasive approach where a small opening is made behind the ear, to access the brain. It is commonly used for the conditions that affect the side of the brain, such as acoustic neuroma removal. The keyhole design allows for less tissue damage and a quicker recovery as compared to larger craniotomies.
This type of craniotomy involves removing a part of the bone that includes the zygomatic arch and orbital rim. It provides access to the anterior and middle cranial fossa and is often used to treat complex tumors, aneurysms, or other conditions in this area. The surgical approach requires specialized training and expertise due to its proximity to critical structures like the eye and optic nerve.
This craniotomy involves accessing the brain through the inner ear (labyrinth) to reach the cerebellopontine angle. It is primarily used to remove acoustic neuromas or vestibular tumors that develop near the balance and hearing nerves. The procedure provides direct access to the tumor while minimizing the risk of damage to surrounding brain tissue.
Here is a general procedure of craniotomy:
Anesthesia: The anesthesia is administered to prevent any discomfort and pain during the procedure. The anesthesia either numbs the whole body or just the part under surgery.
Positioning: Once under anesthesia, the patient is placed in a specific position on the operating table, to access the area of the brain.
Head Shaving and Sterilization: The surgeon shaves the scalp at the targeted incision site and thoroughly sterilizes the surgical area to minimize infection risk.
Incision: A carefully planned incision is made on the scalp, the size and location of which depend on the type of craniotomy and the condition of the brain being treated.
Flap Creation: Using a high-speed drill, the surgeon removes a section of the skull bone and creates a bone flap. This flap is temporarily set aside, exposing the dura mater, the protective covering of the brain.
Dural Opening: An incision is made in the dura mater to access the brain tissue beneath that allows the surgeon to perform the necessary procedures, such as tumor removal or vascular repairs.
Brain Surgery: With the brain exposed, the required surgical intervention is performed like removal of tumors, abnormal brain tissue, or other issues.
Hemostasis: Throughout the surgery, the surgical team carefully controls bleeding to maintain visibility and prevent excessive blood loss.
Dural Closure: After completing the brain procedures, the dura mater is sutured back in place, which provides the protection to the brain.
Bone Flap Replacement: The temporarily removed bone flap is repositioned onto the skull and secured with plates, screws, or wires.
Wound Closure: The scalp incision is sutured closed using either absorbable or non-absorbable sutures, depending on the type of craniotomy.
The cost of a Craniotomy Surgery in India ranges from ₹ 2,45,000 to ₹ 4,10,000. The cost can vary according to the skill of the surgeon, the facilities of the hospital and the condition of the patient at the time of surgery. complications during the procedure can also change the total cost of surgical craniotomy.
Treatment Cost in India | Min in INR | Max in INR |
Craniotomy surgery | ₹ 2,90,000.00 | ₹ 3,90,000.00 |
Some of the indications of craniotomy are:
Some of the risks factors associated with craniotomy are:
Infection Risk
During a craniotomy, there is a risk of infection at the surgical site. Sometimes, infection appears late after the surgery.
Bleeding
There is a risk of bleeding during or after the procedure and it increases the risk of stroke and associated complications.
Brain Swelling
After the brain is exposed during the surgery, there is a risk of swelling that may increase the pressure within the skull and can cause further complications.
Seizures
Some patients may experience seizures during or after the craniotomy due to the irritation of nerves in the brain during surgery.
Blood Clots
Blood clots can form anywhere in the body after surgery due to lack of movement. The clots can travel to major organs and block the major blood vessels and produce complications.
Anesthesia Risks
General anesthesia carries risks of allergic reactions and infertility in young patients.
Cranial Nerve Damage
There is a risk of cranial nerve damage during the surgical procedure that can lead to issues with vision, hearing, or facial movements.
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