CPT® Code 62120

An encephalocele is a congenital defect characterized by the protrusion of intracranial contents through an abnormal opening in the skull. This condition can manifest in various forms, with the protruding material potentially consisting of cerebrospinal fluid, brain tissue, or both. Encephaloceles are primarily categorized based on their location: those that emerge from the skull vault and those that arise from the skull base. Cranial vault encephaloceles typically present as external bulges on the outer surface of the skull, often found along the suture lines in regions such as the frontal, parietal, or occipital areas, and occasionally at the pterion. In contrast, skull base encephaloceles are further divided into frontoethmoidal encephaloceles, which extend forward and create a mass in the facial area, and basal encephaloceles, which project downward into the nasopharynx. The surgical procedure for repairing an encephalocele involves several critical steps tailored to the specific characteristics of the defect and its contents. The operation begins with the creation of a skin flap to provide access to the encephalocele. Subsequently, burr holes are drilled into the skull, and a saw is utilized to connect these holes, forming a bone flap that encircles the defect. The bone flap is then lifted to expose the encephalocele, allowing the surgeon to identify the stalk. Depending on whether brain tissue or other structures are present, the procedure may involve ligating the stalk and excising the encephalocele or reducing the tissue back into the skull vault before excision. The dura mater is subsequently repaired using sutures or a patch graft, and the bone flaps are replaced and secured using various techniques, including bone grafts, bone wax, sutures, wires, or miniplates and screws. This comprehensive approach ensures the effective repair of the encephalocele and restoration of the skull's integrity.