Craniotomy is a type of surgery in which a bony opening in the skull is created through cutting. A bone flap, also known as a bone flap, is removed from the patient’s skull in order to access the brain underneath. The extent of a craniotomy will depend on the presenting medical condition. Brain tumours, hematomas (blood clots), aneurysms or AVMs, traumatic head injuries, foreign objects (bullets), swelling of the brain, and infections are some of the conditions that this procedure can treat. At the very end of the procedure, the bone flap is typically replaced with a few very small plates and screws.
Craniotomies get their names from the part of the skull that is cut away during the procedure. Following the completion of the problem’s correction by the surgeon, the bone flap may then be replaced or covered with plates and screws. A craniectomy is the name given to the operation when the bone flap is not replaced during the procedure.
Craniotomy Surgery Types
Here are some of the most different ways to do a craniotomy surgery:
Long-term bifrontal cranial surgery:
This procedure is used to remove meningiomas, esthesioneuroblastomas, malignant skull base tumours, and tumours that can’t be taken out with a less invasive method. In this process, a short cut was made in the frontal bone of the head so that the tumour could be removed without affecting the mind.
Supra-Orbital Craniotomy:
The supraorbital craniotomy, which is also called the “eyebrow” craniotomy, is a less invasive surgery in which a small cut is made in the eyebrow to remove pituitary tumours or tumours in front of the brain. When the tumour is too big for an endoscopic operation through the nose, this method is used.
Orbitozygomatic Craniotomy:
This is done to get rid of hard-to-remove tumours and treat aneurysms. It is done by temporarily removing the bone that gives the clitoris and orbit their shape. This method is used to treat meningiomas, adrenal gland tumours, and cleft palate tumours.
Craniotomy of the Translabyrinthine:
The cut for this type of craniotomy is made just behind the ear. So, the mastoid bone and some of the bones inside the ear were taken out to get rid of the tumour without hurting the brain. This surgery fixes an acoustic neuroma, but the only bad thing about it is that you lose your hearing.
Craniotomy procedure
You are going to have one or more preoperative appointments with your neurosurgeon before the surgery. These appointments will help you get ready for the procedure.
They will put you through a series of tests to ensure that you are healthy enough to undergo the procedure. This will most likely include the following:
- examination of the body
- blood tests
- imaging of the brain during the neurological exam (CT or MRI)
Your medical condition and the method of craniotomy will both play a role in the decision regarding the location of the surgical incision.
After midnight on the night before your surgery, you won’t be allowed to eat anything because you’ll be fasting. It is also possible that you will need to use antiseptic shampoo on your hair.
Your surgeon may direct you to take additional preparatory measures, but those will depend on the nature of your condition.
When you get to the surgery for the operation, you will have to take off all of your clothes and jewellery. You are going to dress in a hospital gown.
On the operating table, you will either sit or lie down for the procedure. The part of your brain that is being operated on determines the optimal position for the incision. Your head will be held in place by a device that fits over it.
You will need to have an intravenous line inserted into either your arm or hand. After administering general anaesthesia, a urinary catheter will be inserted into your bladder.
When the anaesthesia has successfully put you to sleep, your surgeon will shave the area where the operation will take place. In addition to that, they will clean the area in order to lessen the likelihood of infection.
The incision that will be made on your scalp will be made by your surgeon. They will use a medical drill and saw to cut away what is known as a bone flap once they have located it.
Following this step, your neurosurgeon will make an incision in the dura mater in order to access the brain. The dura mater is the most superficial membrane that covers the brain.
Your surgeon is the one who will carry out the procedure and take tissue samples, if those are required.
Following the completion of the procedure, the tissue will then be stitched back together. They are going to remove the bone flap and replace it with either wires, stitches, or plates.
The incision made in your skin will then be closed using stitches or staples, and a sterile bandage will be applied. The Craniotomy Surgery typically takes between two and two and a half hours.
Craniotomy Surgery Risks
Complications are always a possibility with any kind of surgical procedure. The risks associated with brain surgery are directly proportional to the region of the patient’s brain that will be operated on. If, for instance, an operation is performed on the region of the brain that is responsible for controlling speech, then speech may be affected. The following are examples of some more general complications; however, this list is not exhaustive:
- Infection
- Pneumonia (infection of the lungs) (infection of the lungs)
- Clots of blood form
- Bleeding
- Seizures
- The dangers inherent in the administration of general anaesthesia
- Unstable blood pressure
- Brain swelling
- A loss of cerebrospinal fluid due to a leak (the fluid that surrounds and cushions the brain)
- Weakness in the muscles
The following complications are uncommon and generally relate to specific regions within the brain; as a result, they might or might not be valid risks for certain people:
- Difficulty in Communicating
- Coma
- Memory problems
- abnormalities in either one’s equilibrium or coordination
- Paralysis
There is a possibility of additional dangers, depending on the nature of your current medical condition. Before the procedure, you should go over any worries or concerns you have with your primary care physician.
Recovery after Craniotomy Surgery
After 10 to 14 days have passed since surgery, a follow-up appointment is scheduled. The length of time it takes to recover can range anywhere from one to four weeks, depending on the underlying condition being treated and the patient’s overall health. It could take up to eight weeks for the patient to fully recover.
Beginning to increase your activity level by walking is a great way to get started. Take care not to overstretch yourself, particularly if you are still undergoing treatment with chemotherapy or radiation. Inquire with your surgeon about the time frame in which you can anticipate returning to work.
Even after you have made a full recovery, it is imperative that you continue to take care of yourself. This will assist in managing any future complications and will improve your outlook over the long term.
Maintain your regular appointments with your doctor for follow-up care. It is also a good idea to:
- Maintain a regular exercise routine, eat a healthy diet, and limit or avoid the consumption of alcohol.
- quit smoking (this can be a difficult, but a doctor can help create a plan that works for you)
- get enough sleep
Is a craniotomy a high risk surgery?
Most people who have a craniotomy don’t have any big problems afterward. People who work with an experienced brain surgeon also tend to have the best results, since surgeons who do these complicated procedures often tend to have the most refined techniques.
In 2021, the 30-day and 180-day Craniotomy surgery success rate for meningioma patients who had an infratentorial craniotomy were both 100%.