METHOD FOR REMOVING NEOPLASM OF POSTERIOR-MEDIAL PART OF ORBIT WITH INTRA- AND EXTRACONICAL LOCALIZATION Russian patent published in 2019 - IPC A61B17/00 A61B17/24 A61B1/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery. To remove a neoplasm of the posterior-medial part of the orbit with intra- and extraconical localization, the uncinate process is removed, partial resection of the middle turbinate, widening of the maxillary sinus anastomosis, anterior and posterior ethmoidectomy, visualization of the optic canal above the optocarotic pocket, removal of the ethmoid bone plate and periorbita, mobilization of the orbital tissue with a shaver blade using resection thereof, transnasally in the depth of the orbit, visualization and selection of the medial and inferior rectus muscles, removal of the tumor located at the top of the eye socket, performing plastics of the medial wall of the orbit with free mucoperiosteal flap. At the first stage of the operation, the medial and lower rectus muscles of the eyeball at the place of their attachment to the eye are isolated and taken to the suture-holders. In the second stage, septoplasty is performed. At the third stage of the operation, the uncinate process is removed, a partial resection of the middle turbinate is carried out, along with the expansion of the maxillary sinus anastomosis, then the anterior and posterior ethmoidectomy are performed. Frontonasal canal, the channels of the anterior and posterior ethmoid arteries are identified as the main anatomical landmarks on the basis of the skull, in addition to visualization of the optic canal above the optocarotic pocket, the parasellar and paraclival parts of the internal carotid canal are visualized. Incision of the ethmoid bone plate and the periorbita are performed from front to back up to the bone canals of the anterior and posterior ethmoid arteries. Orbital tissue is mobilized with resection thereof to provide access to the tumor, in the depth of the orbit, the medial and inferior rectus muscles are visualized and separated transnasally in the orbit, which are tightened from the side of the eye by the seams-holders, applied at the beginning of the operation. Then, depending on the location of the tumor, the medial rectus muscle is shifted up or down using a hook. Tumor is visualized, delivered to the nasal cavity and removed. Free mucoperiosteal flap is fixed with a sponge swab with a high absorbency.

EFFECT: method provides direct access to the tumor, which reduces trauma to the orbital tissues.

1 cl, 15 dwg, 1 ex