BERRYCN
New
Hello. Our ENT docs performed repair of tegmen defect with Medpor and DuraMatrix grafts after Neuro performed craniotomy for exposure of the middle cranial fossa. What CPT is used for the repair?
OPERATIVE FINDINGS:
The craniotomy and exposure of the middle cranial fossa was performed by our neurosurgical colleagues.
Examination of the skull base revealed multiple subcentimeter skull base defects. The otolaryngology team repaired the defect with Medpor and DuraMatrix.
DESCRIPTION OF PROCEDURE:
Informed consent was obtained. The patient was brought to the operating suite. General endotracheal anesthesia was administered, and the head of the bed was turned 180 degrees. Our neurosurgical colleagues then placed a lumbar drain. The head was shaved and pinned. The neurosurgery team then performed a left middle cranial fossa craniotomy, exposing the middle cranial fossa. The otolaryngology surgical team entered for repair of the defect. The operating microscope was utilized to visualize the defect. The temporal bone and middle cranial fossa were examined with findings noted as above. The defect was measured and MEDPOR and DuraMatrix were trimmed to cover the entire defect. The MEDPOR and DuraMatrix were sutured together. The grafts were then placed over the defect with the DuraMatrix towards the bone and the MEDPOR towards the dura. The grafts were noted to be in proper position, covering the entire defect. The patient was then turned over to our neurosurgical colleagues for the remainder of the procedure. Please see their separately dictated operative note for details of that portion of the procedure. Once the wound was closed, the patient was turned over to Anesthesia for emergence.
OPERATIVE FINDINGS:
The craniotomy and exposure of the middle cranial fossa was performed by our neurosurgical colleagues.
Examination of the skull base revealed multiple subcentimeter skull base defects. The otolaryngology team repaired the defect with Medpor and DuraMatrix.
DESCRIPTION OF PROCEDURE:
Informed consent was obtained. The patient was brought to the operating suite. General endotracheal anesthesia was administered, and the head of the bed was turned 180 degrees. Our neurosurgical colleagues then placed a lumbar drain. The head was shaved and pinned. The neurosurgery team then performed a left middle cranial fossa craniotomy, exposing the middle cranial fossa. The otolaryngology surgical team entered for repair of the defect. The operating microscope was utilized to visualize the defect. The temporal bone and middle cranial fossa were examined with findings noted as above. The defect was measured and MEDPOR and DuraMatrix were trimmed to cover the entire defect. The MEDPOR and DuraMatrix were sutured together. The grafts were then placed over the defect with the DuraMatrix towards the bone and the MEDPOR towards the dura. The grafts were noted to be in proper position, covering the entire defect. The patient was then turned over to our neurosurgical colleagues for the remainder of the procedure. Please see their separately dictated operative note for details of that portion of the procedure. Once the wound was closed, the patient was turned over to Anesthesia for emergence.