SURGERY TECHNIQUE FOR JUVENILE NASOPHARYNGEAL ANGIOFIBROMA, INCLUDING EXTENDED INTO NASAL CAVITY AND BASILAR SINUS Russian patent published in 2009 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention refers to medicine area, namely to otorhinolaryngology and can be used in practical surgery for treating juvenile angiofibroma. Substance of the technique implies the preoperative comprehensive examination of a patient to determine extension and nature of juvenile angiofibroma to be removed from access through maxillary sinus and nasal cavity. Herewith, 3-4 days prior to the surgery, endovascular occlusion of maxillary artery is performed. After general anesthesia followed by tracheal intubation and provided artificial pulmonary ventilation, 5-10 minutes prior to the surgery, blood exfusion in amount 0.5-1.5 litres is combined with crystalloid infusion in amount 0.5-1.5 litres to level the arterial pressure to 100-110/60-70. Transitory fold of upper lip is incised. After haemostasis, facial wall of maxillary sinus and piriform opening are uncovered. Maxillary sinus is open within canine fossa to remove maxillary frontal process, nasal bone, lacrimal bone and nasal process of frontal bone with making an access to angiofibroma and uncovering angiofibroma located in maxillary sinus and nasal cavity. A mouth-gag is established, and fixed angiofibroma is stripped with a surgeon's finger and a big round bone scraper. Total separation of angiofibroma from nasopharyngeal roof is followed with dislocation of the whole mass of moving angiofibroma into trepanation cavity with ovum forceps and complete removal thereof. Haemostasis of surgical area and posterior nasal packing are performed to introduce a tampon into maxillary sinus. Transitory fold mucosa of upper lip is sutured. Then the surgery termination stage involves complete reinfusion of a patient's autoblood.

EFFECT: application of the given invention allows for considerably reduced intraoperative haemorrhage, and for visual access to angiofibroma to be removed and inspection of trepanation cavity to evidence radical removal of total volume of angiofibroma.

3 ex, 2 cl