lingual lymphangioma resection

Treatment of diseases: lymphangioma Indication Tongue lymphangioma (mega-tongue) can cause abnormal teeth and jaw malformation, and affect the function and shape of the oral organs. It should be surgically removed and the residual part of the tumor can be treated with sclerotherapy or cryotherapy. Preoperative preparation When the lymphatic vessels of the tongue are infected, surgery should be performed after infection control. Blood should be used before surgery. Other preoperative preparations are as usual. Surgical procedure Incision Can be made as a "V" shape or a double "V" shaped incision. For the "V" shape design, the O point is defined at the posterior portion of the center line of the tongue, and the A point and the A' point are determined on both sides of the tongue. After the AOA' wedge-shaped tissue is removed, the A point and the A' point are stitched to form a new tongue tip. Therefore, when the A point and the A' point are fixed, the newly formed tongue tip should be located on the inner side of the lower anterior teeth, that is, let O~A =O~A' and is equal to the distance from point O to the lower front teeth. For the double "V" shape design, since the O point is the new tongue tip, the O point should be inside the lower front arch, and the O' point should be set on the ventral surface of the tongue tip. Point A and point A are fixed on both sides of the tongue 2. Excision of diseased tissue In order to reduce intraoperative bleeding, the blood supply of the tongue can be temporarily blocked, that is, the needle is inserted from the center line of the tongue near the base of the tongue with a large round needle and a thick thread, and the tongue is passed out from the side edge of the tongue and the bottom of the mouth. Edge ligation. When using the "V" shaped incision design, the O~A line and the O~A' line should be cut in the full layer of the design, and the wedge-shaped lesion tissue in front of the giant tongue is cut. When adopting the double "V" shape slit design, the O'~A line and the O'~A' line should be cut first, and cut obliquely inward and upward, cut to the deep layer, be careful not to cut the bottom of the mouth; then cut the O Lines ~A and O~A' are cut obliquely inward and downward, cut to the deep layer, and communicated with the A~O' line and the A'~O' line cut. At this point, a double wedge-shaped tissue at the front of the giant tongue is cut. 3. Wound treatment Firstly, the suture line at the back of the tongue is removed, the active bleeding point on the wound surface is ligated, the wound is washed, the muscle layer is sutured, and the mucosa is finally sutured. And place the rubber drain strip. complication The main complications after tongue lymphangioma resection are postoperative hemorrhage, hematoma formation and tissue edema, and upper airway obstruction due to local swelling and tongue fall. Therefore, it is necessary to completely stop bleeding during the operation, and the muscle layer should be tightly sutured. When the mucosa is sutured, the suture type and the intermittent suture should be used, and the rubber drainage strip should be placed. After the operation, it is necessary to observe closely. If the local swelling develops rapidly, it should be treated in time to prevent suffocation.

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