By Dr. Ravindra Patil
Craniotomy is a surgery, but not to treat one specific disease. Craniotomy means opening the skull to do brain tumour surgery or epilepsy surgery. The word craniotomy has two parts: Cranium and Otomy.
The word Cranium originates from the Latin language. It means the skull. And ‘Otomy’ comes from the Greek language and it means cutting into a part of the body. Most medical terminology is from Latin and Greek. Thus, a gastrotomy would be cutting into the stomach, a pharyngotomy means cutting into the pharynx. In the same way, craniotomy means cutting into the cranium or skull.
In this surgery for the brain, a part of the skull is removed to access the brain. The bone is replaced when the surgery is done. Craniotomy is done to remove brain tumours, treat brain aneurysms, treat epilepsy, treat cerebral haemorrhage, to decrease intracranial pressure and so on. Neurosurgeons performs the procedure.
When such a major surgery is mentioned, the subject of cost must be cleared. Brain surgeries may cost between one lakh to five lakhs or more. But there are options like Ayushman Bharat Yojana, health insurance or employer given benefits to cover the costs. If you have none of the above benefits, it is highly advisable to buy a medical insurance.
Various tests are done to confirm that the patient can safely undergo the procedure. They are:
On the night before surgery, the patient will be NBM [nil by mouth]. Scalp will be shaven.
During the procedure the patient lies down on the operating table. The position depends on the part of the brain being operated on. Intravenous line is inserted into your arm or hand. A urinary catheter into the patient’s bladder. And then general anaesthesia is given. Surgery is done with a knife, a medical drill and a saw. Then the brain tumour operation, epilepsy surgery or brain haemorrhage is done. Then the surgeons fix the bone with wires, stitches, or plates either immediately or a few months later. Finally the skin will be stitched or stapled. A sterile dressing and a sterile bandage are applied. Craniotomy surgery may take about three to four hours.
There are many types of craniotomies. Each type is named for the technique or location used in the surgery.
If in a craniotomy the skull is fixated with a stereotactic frame and uses an MRI or CT scan, it’s called a stereotactic craniotomy.
Done through a tiny incision in the skull through an endoscope.
An awake craniotomy is done while the patient is awake.
A keyhole craniotomy is used to remove brain tumours. It’s a minimally invasive surgery.
A supra-orbital means surgery above the eye sockets, done to remove brain tumours in the front of the brain.
In the skull, the pterion is where the frontal, temporal, sphenoid, and parietal bones meet. It involves removing part of the pterion.
Difficult tumours and aneurysms may be treated with an orbitozygomatic craniotomy. The surgeon temporarily removes part of the bone that creates the curve of your orbit, or eye socket, and cheek.
This is done through an incision at the base of the skull.
In a translabyrinthine craniotomy, the surgeon makes a cut behind a ear.
A bifrontal craniotomy, or extended bifrontal craniotomy, is done to remove difficult tumours in front of the brain.
As the cost for brain tumour surgery in India is becoming affordable through various schemes to everybody, these surgeries are done often. A craniotomy is done to treat the following conditions of the brain:
A brain tumour after removal is usually sent for a biopsy. Brain tumour surgery cost in India is not as high as most people think.
The risk of complications depends on many factors, including the patient’s specific brain surgery and medical condition. Possible complications include:
Rarely, a craniotomy may lead to:
A craniotomy can also cause general surgical side effects like:
However, the surgeon is the best person who can explain about these complications.
Immediately after surgery the patient is taken to the recovery unit or intensive care unit [ICU]. Nurses closely monitor the patient’s vitals as he/she gradually come out of anaesthesia. Then the patient is shifted to a room. Hospital stay will depend on type of surgery but may be as long as a week.
During this crucial recovery period:
After a craniotomy, the head wound care is critical. Medicines for pain and infection prevention are to be taken till the would heals. Recovery may take at least 6 weeks. The patient must take extreme care while attempting routine activities like:
Physiotherapy, occupational therapy and speech therapy is usually advised. And of course, rest is necessary. The patient needs to visit his/her hospital for wound dressing and functional brain assessment. A long rest is required after brain surgery and during that time the patient cannot do any productive earning work, and this increases the brain surgery cost in India.
After the patient has fully recovered, it’s still important to take care. This will help manage future complications and improve the long-term outlook. After recovering from such a major surgery, it is highly advisable to:
Like in all surgeries, a craniotomy can cause complications like pain, haemorrhage, infection and so on. But surgeons will treat them if the occur. Patients must contact the hospital immediately if he/she has severe headaches, seizures, or signs of a wound infection.
Craniotomy means opening the bone, not a specific surgery. It can be done in large and medium sized cities in India. Cost of brain tumour surgery in India is affordable even to the poorest through AB-PMJAY yojana or through medical insurance to others.
Samarth Neuro and Superspeciality Hospital has 100+ beds & specializes in emergency surgery for neurological issues/disorders & diagnostics.
Samarth Neuro and Superspeciality Hospital
