CPT® Code 61606

Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft

The CPT® Code 61606 refers to the surgical procedure involving the resection or excision of neoplastic (tumor-related), vascular, or infectious lesions located in the infratemporal fossa, parapharyngeal space, and petrous apex. This procedure is classified as intradural, meaning it involves entering the endosteal dura, which is the protective layer surrounding the brain. The approach to access these areas is typically performed through a separately reportable method, allowing for a thorough exploration of the extradural space, which lies between the periosteal dura attached to the skull and the endosteal dura. During the procedure, the surgeon carefully removes any identified lesions while ensuring the preservation of critical anatomical structures, such as the maxillary artery and the trigeminal nerve along with its branches. The procedure may also involve examining and potentially resecting the cartilaginous Eustachian tube, as well as exploring the parapharyngeal space for any additional lesions. The pterygoid muscles are assessed, and if necessary, resected while taking care to preserve or ligate the pterygoid venous plexus. Furthermore, the procedure may require drilling or chiseling of the lateral and medial pterygoid plates and the petrous apex to effectively remove lesions. After the excision, any defects in the dura mater are repaired using sutures or graft materials to ensure a watertight seal, thereby preventing cerebrospinal fluid leakage. The procedure concludes with the closure of the incision in layers, which may involve wiring the zygomatic arch and using staples for the skin closure.