METHOD FOR EXERCISING APPROACH IN SURGICAL MANAGEMENT OF MAXILLARY NEW GROWTHS Russian patent published in 2015 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: provided an external skin transfacial incision is eliminated, a superior conjunctival approach within an inferior eyelid is exercised towards a floor of the orbit: at 2 mm below an inferior border of a tarsal plate of the inferior eyelid, the conjunctiva is incised throughout the lateral 3/4 length of the latter. Having the structure of a moderate lamella identified, a preseptal dissection along an inferior border of the later is performed. At this stage, an orbital muscle of the eye is mobilised in the flap with superajacent skin along a loose connective-tissue preseptal layer with identifying and preserving anatomical integrity of small branches of a zygomatic branch of a facial nerve innervating a preseptal portion of the orbital muscle of the eye, keeping the orbital muscle of the eye and an eye septum intact. Once reaching the anterior border of the inferior orbital wall, a periosteum is dissected throughout the wound. The floor of the orbit is mobilised in the sub-periosteal direction to the level of an infraorbital fissure in the distal direction. A support ligament of the orbital muscle of the eye, the orbital muscle of the eye to the level of a lachrymal caruncle, greater and smaller zygomatic muscles, elevator muscles of angle of mouth and upper lip are dissected away sharply from the anterior border of the inferior orbital wall. In this layer, the dissection is performed up to an alveolar opening, a submucous membrane of an oral vestibule. Within a lateral border, a canthal ligament of the inferior eyelid is identified and dissected away; an external surface of the zygomatic bone is skeletonised in the subperiosteal direction with the dissection continued laterally to the border of anterior and middle one-thirds of the maxillary arch. A masseter tendon is dissected away from the maxillary arch throughout anterior 3-4 mm, and tumour resection is performed according to the common technique.

EFFECT: method enables preserving the anatomical integrity of the facial muscles, accelerates the rehabilitation time, minimises the risk of inferior eyelid malposition and eyeball dystopia.

13 dwg, 1 ex