CPT® Code 61580

Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration

The CPT® Code 61580 refers to a surgical procedure known as a craniofacial approach to the anterior cranial fossa, specifically performed in an extradural manner. This procedure is designed to expose extradural lesions, which are abnormal growths located outside the dura mater, the outermost layer of the protective covering of the brain. The approach begins with a lateral rhinotomy, which is an incision made along the side of the nose, extending around the nasal ala and down the center of the lip. This incision is complemented by a second incision that runs from the upper side of the nose to the inner canthus of the eye, continuing below the eye to the outer canthus and along the maxilla into the temporal region. During the procedure, the facial nerve is carefully mobilized and transected, ensuring that it can be reconnected at the end of the surgery. A subperiosteal dissection is performed to reach the intraorbital nerve, which is also transected and tagged for identification. A flap is created that includes the upper lip, cheek, lower eyelid, and parotid gland, allowing for better access to the surgical site. The procedure involves the complete resection of the mucosa and bone of the ethmoid and sphenoid sinuses, known as ethmoidectomy and sphenoidectomy, respectively, to facilitate access to the extradural lesion. This surgical approach is typically indicated for the treatment of malignant tumors that may have invaded surrounding structures, providing a comprehensive method for addressing complex craniofacial conditions.