METHOD OF ACCESSING UPPER JAW AND ZYGOMATICO-ORBITAL COMPLEX IN SURGICAL TREATMENT OF TUMORS Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, and is intended for use in the treatment of tumor processes of the upper jaw and the zygomatico-orbital complex. Biconarotransconjunctival-transoral access is performed: scalp is cut through the scalp in the frontal and temporal region, including region behind the median line, the aponeurotic skin, the anterior trancranial vascularized flaps are cut out from the temporal muscle and the fascia, then skeletonized: the zygomatic bone, the scales of the frontal and temporal bones, the large wing of the sphenoid bone, single-patch craniotomy is performed with removal of the bone flap, the bone structures of the bottom of the left half of the anterior and middle cranial fossa is skeletonized by a subfrontal approach. Osteotomies of the sphenoidal site and sieve plate are performed, the conjunctiva is dissected in the standard marking of the upper conjunctival approach, the circular muscle of the eye is mobilized in the flap with proper skin, producing preseptal dissection to the base of the septum, the periosteum is dissected along the entire length of the wound, the bottom of the orbit is subperiosteally mobilized, retaining ligament orbicular muscle of the eye is cut, along with orbicular muscle of the eye to the level of the lacrimal caruncle, zygomaticus major and minor muscles, levator angluli oris, levator of upper lip, as well as the maxillary bone and skin ligament, producing a dissection to the level of the alveolar opening. Cut the lateral canthal ligament of the lower eyelid, keeping the lateral orbital seal, skeletonize the zygomatic bone subperiosteal to the border of the anterior and middle third of the zygomatic arch, cutting off the ligament of the masticatory muscle over the front 3–4 mm, dissect the mucous along the upper mucobuccal fold of the vestibule of the mouth from the level of the first incisor to the tuber, continuing the incision along the median line to the border of the hard palate to the soft palate, and dissect the mucosa along the posterior edge of the palate with the joint of the mouth sections into a single line.

EFFECT: method allows to exclude traumatization of the branches of the facial nerve, external percutaneous intersection of the superficial musculoaponeurotic system, cuts and scars in socially significant visible areas of the face, eliminate functional and aesthetic complications, shorten the duration of surgery, speed up the healing process and thereby reduce the duration of the patient's stay in the hospital.

1 cl, 11 dwg, 1 ex