parotid fistula resection

Treatment of diseases: suppurative mumps salivary gland infection Indication Cleft palate often combined with infection, recurrent inflammation, it should be surgically removed after acute inflammation control. However, if the sputum is small, there are few secretions or secretions, and children under 2 years of age should be suspended. Preoperative preparation Routine lipiodol angiography should be performed before surgery to understand the direction, depth and path of the sacral approach. Blood transfusion preparation should also be done. Surgical procedure Incision When the mouth is 1/3 of the neck, two horizontal incisions should be used, that is, a transverse fusiform incision along the skin around the lower neck and a larger transverse incision at the bifurcation of the common carotid artery. However, if the position of the mouth is high, make a horizontal incision. 2. Stripping the fistula Methylene blue is first injected from the mouth to facilitate identification of the fistula during separation. After cutting the skin, subcutaneous tissue and platysma along the incision, the hemostasis was used to clamp the fusiform skin containing the fistula, followed by sharp separation along the fistula. Gradually separate from the bottom to the bifurcation of the common carotid artery, a second transverse incision is made in this plane, and the separated tibial cord tissue is pulled out of the skin from this transverse incision. Since the fistula often passes between the internal and external arteries of the neck and then folds to the side wall of the pharynx, it is necessary to carefully separate the fistula from the internal and external carotid arteries and then pull the external carotid artery forward. At the same time, the posterior and sublingual nerves of the second abdominal muscles need to be pulled upward. Then continue to separate inward along the fistula to the pharyngeal wall. At this point, the assistant pushes the side wall of the pharynx with a finger to make the fistula lighter and help to separate. If the operation is difficult, the probe can be inserted from the pharyngeal wall fistula opening, and the lower part of the separated fistula can be removed, the probe is passed out from the fistula incision, and the lower end of the upper section of the fistula is tightly ligated to the probe. The probe is then slowly withdrawn from the pharynx, and the fistula is then pulled out of the mouth. Then, around the inner mouth of the fistula, a purse-string suture is made on the mucosa of the pharyngeal side wall, then all the fistulas are removed, and the purse string is tightened and ligated. complication The main complications of cleft palate resection include important neurovascular injury in the neck and postoperative bleeding. The causes and precautions are as described above. It should also be noted that postoperative pharyngeal wall edema and parapharyngeal hematoma can cause difficulty in breathing and should be closely observed and treated in time.

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