CPT® Code 62117

1. Indications

The procedure is indicated for patients with craniomegaly, which may be due to various underlying conditions, particularly hydrocephalus. The following are specific indications for performing this surgical intervention:

• Hydrocephalus A condition characterized by an accumulation of cerebrospinal fluid within the brain's ventricles, leading to increased intracranial pressure and an enlarged skull.
• Abnormal Skull Growth Conditions that result in excessive growth of the skull bones, necessitating surgical intervention to prevent complications.
• Neurological Symptoms Presence of symptoms such as headaches, cognitive impairment, or developmental delays that may be associated with increased skull size and pressure on the brain.

2. Procedure

The procedure involves several critical steps to ensure the effective reduction of the craniomegalic skull:

• Step 1: Anesthesia Administration The patient is placed under general anesthesia to ensure comfort and immobility during the surgical procedure.
• Step 2: Craniotomy The surgeon makes an incision in the scalp and removes a section of the skull to access the brain. This step is crucial for allowing the surgeon to manipulate the skull bones directly.
• Step 3: Bone Separation Each bone of the skull is carefully separated. This meticulous dissection is necessary to avoid damage to the underlying tissues and to facilitate the removal of excess bone.
• Step 4: Bone Resection The surgeon removes a portion of the skull bone to reduce the overall size of the skull. This step is tailored to the individual needs of the patient based on the degree of craniomegaly.
• Step 5: Bone Grafting (if necessary) If required, the surgeon may obtain bone grafts to assist in reconstructing the skull. This may involve using the patient's own bone or donor bone to fill in any gaps and ensure proper alignment.
• Step 6: Reattachment of Skull Bones After the necessary adjustments are made, the surgeon reattaches the skull bones, ensuring they are properly aligned and secured.
• Step 7: Closure The incision in the scalp is closed using sutures or staples, and the patient is monitored during the recovery phase.

3. Post-Procedure

Post-procedure care involves monitoring the patient for any signs of complications, such as infection or excessive bleeding. Patients may experience swelling and discomfort in the surgical area, which can be managed with pain relief medications. Follow-up appointments are essential to assess the healing process and ensure that the skull is properly aligned. Rehabilitation may be necessary to address any neurological deficits that may have been present prior to surgery or that arise as a result of the procedure. The overall recovery time can vary based on the individual patient's condition and the extent of the surgery performed.