METHOD OF SURGICAL TREATMENT OF PHLEGMONS OF DEEP FATTY FACE SPACES Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention pertains to medicine, namely to surgical dentistry and maxillo-facial surgery, and may be used in surgical treatment of phlegmons of deep cellular facial spaces. Essence of the method consists in making two incisions of the skin: one - in the temporal area along the anterior edge of the temporal muscle upward from the jugal bridge at the length of up to 4.0 cm, the second - in postmundibular area between the front edge of the nodding muscle and posterior edge of the ramus of mandible frontward to the posterior edge of submandibular salivary gland, backing out of the relative point of the angle of the lower jaw along the upper cervical fold by 3.0 cm upwards and by 1.5-2.0 cm downwards. Through the upper incision in the temporal area tissues are incised layer by layer, reaching the centre of the infectious - inflammatory focus of the temporal area - between - the temporal muscle and cranial bones. Revision and removal of purulent discharge is conducted from superficial and deep departments of the temporal area and interfascial temporal space, subtemporal and pterygopalatine fossae. Through the lower incision tissues are incised layer -by -layer; low-back portion of the parotid gland is incised with the capsule from the front edge of the nodding muscle and of submandibular salivary gland. Low-back lobe of the parotid gland is moved up and frontward, back margin of the ramus of mandible is exposed, tendons of the medial pterygoid muscle are incised along the back internal margin of the ramus of mandible by 10-15 mm. Medial pterygoid muscle is moved inward, fatty space between the inner surface of the ramus of mandible and outer surface of the medial pterygoid muscle is dissected, posterior edge of submandibular parotid gland is moved forward and downward, adipose tissue of the peripharyngeal space is dissected along the posterointernal surface of the medial pterygoid muscle up-and-inward. Purulent discharge from the pterygoid-mandibular, anterior and posterior departments of peripharyngeal space is observed and removed. Surgical clamp is applied between inner surface of the medial pterygoid muscle and inner surface of the ramus of mandible up to medial side of the zygomatic process of temporal bone. Upper and lower incisions are connected with each other bluntly; antiseptic processing is conducted and perforated rubber tube is introduced for through drainage of deep cellular facial spaces.

EFFECT: use of present invention ensures faster cleaning and high-quality drainage of deep cellular facial spaces, pterygoid-mandibular and all the departments of peripharyngeal space, decreases risk of injuries of ramus of mandible of the facial nerve and further dissemination of purulent-infectious process into cellular spaces of the neck and mediastenium prevents development of the postoperative contracture of the law jaw, reduces traumatic value of the surgery.

2 ex, 1 tbl, 4 dwg