A craniotomy is a major brain surgery in which a bone flap from the skull is temporarily removed to have an access to the brain. This procedure is mainly performed in patients who suffer from traumatic brain injuries or brain lesions. It is a highly critical procedure and a patient may take months to recover from it. This surgery is also conducted prior to the placement of deep brain stimulators, which is often recommended to patients suffering from epilepsy and Parkinson’s disease. This procedure has a wide range of other applications as well such as brain imaging and electrical stimulation.
A craniotomy is a highly sensitive procedure that is performed in some of the top neurosurgery hospitals in Singapore. Because of the sensitivity of the procedure and the risks involved, this surgery should only be conducted by highly experienced and skilled surgeons. The top neurosurgeons in Singapore are educated from some of the most prestigious medical universities in the world. They hold several years of experience in conducting all types of brain surgeries and have so far treated thousands of patients from around the world.
Craniotomy surgery is one of the most common types of brain surgery conducted to treat a brain tumor. It mainly aims at removing a lesion, tumor, or a blood clot in the brain by opening a flap above the brain to access the targeted area. This flap is removed on a temporary basis and again put in place when the surgery is done. Around 90 percent of the cases of brain tumors are diagnosed in adults aged between 55 and 65. Among children, a brain tumor is diagnosed within an age range of 3 to 12 years.
Craniotomy procedures are conducted with the help of magnetic resonance imaging (MRI) scans to reach the location precisely in the brain that requires treatment. A three-dimensional image for the same is achieved of the brain in conjunction with localizing frames and computers to view a tumor properly. A clear distinction is made between abnormal or tumor tissue and normal healthy tissue and to access the exact location of the abnormal tissue.
In a minimally invasive craniotomy procedure, a burr hole or a keyhole may be created to access the brain to fulfill the following purposes:
When there are complex craniotomies involved, the procedure may be referred to as a skull base surgery. In this kind of surgery, a small portion of the skull is removed from the bottom of the brain. This is the region where delicate arteries, veins, and cranial nerves exit the skull. Complicated planning is done to plan such craniotomies and understand the location of the lesions. This type of approach is usually employed for:
Primary brain tumors are much less common than secondary brain tumors. Primary ones are found to originate very close to the brain itself or in the tissues very close to it, such as the covering membranes of the brain, including the meninges, cranial nerves, pineal, or pituitary gland. It begins with normal cells, which at a later period undergoes some mutational errors in their DNA. The mutation triggers cells to grow and divide at a very high rate while healthy cells keep dying around it. This results in a mass of abnormal cells which gives rise to a tumor. Unlike primary tumors, the secondary tumors begin as cancer elsewhere and spread to the brain.
No matter what the goal of the surgery is, it is best to ensure that the incision is made to address the intracranial lesion keeping some principles in mind. A wide variety of intracranial processes can be done via a craniotomy with a different variety of incisions. Some of these variations include frontal craniotomy, pterional craniotomy, temporal craniotomy, decompression craniectomy, and suboccipital craniotomy.
A craniotomy is performed by making a small burr hole incision, a keyhole incision which is comparatively larger than the former, or a larger incision, as required. The complexity of the surgery depends on the region of the brain which is affected and the severity of the disease or the injury. A craniotomy is performed by the following procedure:
The candidate has to remove all kinds of jewelry and accessories and change into the hospital gown.
An intravenous line is made on the arm for providing medications and also fetching blood samples.
Foley catheter is inserted in the urinary bladder for storing the urine and the candidate is made to lie on a suitable position so as the damaged portion of the brain can be easily accessed.
Anesthesia is provided to the individual and the oxygen level, heart rate, as well as blood pressure, is closely monitored by the anesthesiologist.
The incision area and ¼ inch area on either side of the incision is clean shaved and sterilized with antiseptic.
A 3-pin machine is used for fixating the skull and holding the head still.
Skull drilling machines are used to create necessary burr holes and a craniotome (saw) is used for removing the bone flap to expose the dura mater (outermost protective brain layer)
The dura matter is cut open to access the brain. Loupes, dissectors, scissors, drills, etc., are used to penetrate deep and operate.
After completion, the dura matter is stitched back in position and the bone flap is fixed via metal plates made up of titanium and necessary screws.
Temporary tubes may be provided for draining of fluid for the next few days.
The candidacy for craniotomy surgery is primarily important and is decided solely by the neurosurgeons. The deciding criteria which make an individual eligible for craniotomy are:
Failure of prior treatments and medications in curing the disease or the injury.
The candidate shows no sign of long-term or terminal illness.
The candidate should not have any serious sickness apart from the brain ailment.
Singapore is globally recognized as one of the topmost countries that offer unparalleled medical treatments in complex operations like craniotomy. The use of contemporary technology, flamboyant facilities, and globally acclaimed surgeons has made craniotomy in Singapore one of the best in the world. The clinics performing craniotomy for decades are:
Mount Elizabeth Hospital
Mount Elizabeth Novena Hospital
Parkway East Hospital
The surgeons performing craniotomy in Singapore are renowned neurosurgeons with experience of over decades. Decorated with specialists degree from topmost universities in the world, the surgeons have now made the impossible possible. Hence, here are some of the popular surgeons who have excelled the odds in craniotomy.
Dr. Ivan Ng
Dr. Lee Kam-Yiu Timothy
Craniotomy cost in Singapore of anywhere in the world varies as per the complication and extent of surgery required. Apart from that, the cost is also determined by laboratory tests, multispecialty healthcare benefits, medical facilities, and several other factors. Considering the aforesaid factors, craniotomy cost in Singapore has been estimated to be approximately USD $6807.
The post-surgery recovery time for craniotomy requires up to two weeks of observation and follow-ups. Henceforth, complete recovery of the candidate is expected to be achieved within 6 to eight weeks. However, the entire process of recovery depends on how the body responds to resuming activities. In case the candidate needs consecutive chemotherapy or other radiation treatments, the recovery time may be prolonged.
The success rate of craniotomy in Singapore varies approximately from 95% to 99%. The rate varies as per the extent of complications and the part of the brain that is affected, diseased or injured. However, the longevity is quite unpredictable in case of lesions or tumors.
There are several reasons for considering craniotomy in Singapore. These are:
Affordable treatment which is cheaper compared to other major countries like the USA, Israel, etc.
Implementation of modern advancements in medical science
There are several in-general risk factors associated with every operation. Commonly, severe infections, excessive blood loss, and formation of blood clots may occur. Apart from that, the risks specifically associated with craniotomy include:
Leakage of cerebrospinal fluid or the CSF
Impaired nerve function
Swelling of meninges or affected the portion of the brain
Improper nervous reflexes
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