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Suboccipital Craniectomy & Duraplasty

Suboccipital craniectomy refers to a surgical procedure that is performed at the base of the brain in which a portion of the skull is removed to access the surgical objective. The portion of the skull is not replaced, instead, the area is covered with a synthetic substance.

Duraplasty is a type of repair or expansion of dura (the outer covering of the brain) when it has been cut open during surgery. It is often closed with another compatible soft tissue material taken from another part of the body. Duraplasty can also be constructed from inorganic material.

What are some of the reasons suboccipital craniectomy is performed?

Chiari malformation: When chiari is necessary to resolve, we use a suboccipital craniectomy surgery and usually requires duraplasty to complete.

Chiari malformation is a structural defect between the brain and the area of the skull near the base. The skull at the base does not fully grow and doesn’t provide enough room for the brain. As a result, there is a slight displacement of the cerebellum and medulla and the lowest part of the cerebellum – the cerebellar tonsils – is pushed down toward or slightly into the spinal column.

Suboccipital Craniectomy

A craniectomy is performed to provide more space for the brain within the skull and relieve pressure on the spine. Dura tissue is expanded to promote the flow of fluids and duraplasty closes the primary opening. Any neurological issues that require surgery and are located near the back of the head or behind the ears may possibly require a suboccipital craniectomy. Your surgeon at Achieve Brain & Spine will carefully answer all your questions and go over what he feels is the best procedure for your particular case.

Another type of craniectomy is a retrosigmoid craniectomy. One of the most common reasons for this procedure is to remove a benign tumor lodged on the nerve that goes from the brain to the inner ear and controls balance and hearing. The term for it is “acoustic neuroma.” The surgery is done via retrosigmoid craniectomy to gain direct access to the tumor.

What should I expect when undergoing a suboccipital craniectomy?

Depending on your neurological issue, the procedure will vary. The basic process is as follows.

  • You will be fully examined and tested including advanced imaging, so the exact issue is pinpointed. A full body exam will tell the surgeon and attending surgical staff what they need to know to regulate your body during surgery.
  • You will be briefed by your surgeon on what he proposes to do and why. He will go over with you the risks and benefits.
  • You will be given all the data you need so that you are prepared to go smoothly through your procedure. The Achieve Brain & Spine specialists and supporting medical professionals are highly trained and focus on patient health and safety throughout the procedure.
  • In the operating room, that portion of your head that will treated will be shaved and prepared for surgery.
  • During the procedure, all your vitals will be continually checked, including nerve activity. All our brain procedures are precise and most of them employ micro technology to make as small an impact on the body as possible.
  • When the incision is closed up and bandaged, you will be taken to a post-anesthesia care unit where your blood pressure, heart rate and breathing will be monitored.
  • When you are awake and stabilized, your neurological functions will be tested and evaluated.
  • Your hospital stay is likely to be between 2-4 days.
  • If sutures were used, they will likely be removed in a week to two. You will be provided post-operative appointments as well.

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