Preoperative Considerations
Anesthesia/Positioning:
- Prone position with head elevated above heart
- Subcutaneous local anesthetic with epinephrine
- Eye Pads
- Trans nasal intubation preferred
- Two venous lines
Technique
- 1. Patient intubated under general anesthesia in the prone position
- 2. Bircoronal weave incision marked
- 3. Supraperiosteal dissection to minimize bleeding
- 4. Periosteum incised at site of osteotomies and osteotomy line marked on bone
- 6. Ball drill used to make burr holes around the planned osteotomy
- 7. Dural dissectors utilized to separate calvarium and dura between burr holes
- 8. Craniotomy performed with craniotomy or piezotome and bone rongeurs
- 9. Two to four distractors placed in parallel direction
- 10. Skin closure
123456789101112131415161718192021
Postoperative Considerations
Immediate:
- Patient transported to PACU or ICU with extubation as soon as possible.
- Careful patient positioning to avoid pressure ulcers.
Follow Up:
- Two to four week activation period with lateral x-rays to monitor progression
- Distractor devices remain in place for one to six months post-activation for ossification period
Coding
Diagnosis Codes:
- Q75.00 Craniosynostosis unspecified
- Q75.01 Sagittal craniosynostosis
- Q75.02 Coronal craniosynostosis
- Q75.03 Metopic craniosynostosis
- Q75.04 Lamboid craniosynostosis
- Q75.04 Multi-suture craniosynostosis
- Q75.08 Other single-suture craniosynostosis
Procedure Code:
- 61550 Craniectomy for craniosynostosis, single cranial suture
- 61552 Craniectomy for craniosynostosis, multiple cranial sutures
Forms
