parotid ductoplasty
Parotid duct angioplasty is used for reconstruction of the parotid duct. Paralysis of the parotid duct due to trauma or surgery may cause leakage or loss of the catheter. Therefore, catheter reconstruction must be actively carried out. Various reconstruction procedures are selected based on their indications. In recent years, the author (unit) has succeeded in using the proximal gland end anastomosis of the vein and residual catheter in the front. Treatment of diseases: malignant tumor of the salivary gland Indication The parotid duct angioplasty is suitable for the complete separation of the parotid duct, and the proximal end of the duct has a certain length. After the free catheter, the buccal mucosa can be opened and sutured. Contraindications 1. Estimate the length of the residual catheter is not enough. 2. The infection after partial injury is not completely eliminated. 3. There are serious combined injuries. Preoperative preparation 1. Inject methylene blue from the mouth and the catheter mouth 1 day before surgery; prepare a lacrimal sac probe and a hollow hose. 2. Determine the site of injury by parotid angiography. 3. Remove intraoral infections. 4. Other routine preparations before oral and maxillofacial surgery. Surgical procedure 1. Incision and exposure Insert the probe from the fistula port before cutting to serve as a marker for separating the fistula and catheter. A round or fusiform incision was made on healthy skin above 0.5 cm around the fistula, and a transverse incision about 1 cm long and consistent with the direction of the catheter was made before and after the incision. After cutting the skin and subcutaneous tissue, separate the fistula and catheter, and pay attention to retain a part of the tissue around the catheter, which can increase the toughness of the catheter and prevent the fistula from being broken during the operation. In addition, after the transplant was diverted, there was no invalid cavity around the catheter. 2. Diversion of the catheter The cheek muscle was bluntly separated from the buccal muscle by the curved hemostasis to the buccal mucosa of the oral cavity, and the incision was made in the buccal mucosa by about 0.5 cm. Then, 3 needles were sewn at the same distance with the No. 1 thread at the fistula, and the catheter was delivered into the portal. The 3-needle suture was sutured with the buccal mucosal incision. After the operation, the hollow rubber tube was placed and fixed at the buccal mucosa. The extraoral wound was layered and sutured and pressure bandaged.
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