FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely, to dentistry. Before preoperative removal of benign new growths and concrements, volume and topography of new growth or topography of submandibular salivary gland are determined by spiral computed tomography. Under endotracheal narcosis in patient's position on back is performed in submandibular area in projection of submandibular saliva with indention 3 cm from edge of lower jaw incision of epidermis and derma to subcutaneous fat length of 5 cm using an electric knife with a needle nozzle and then dissection of subcutaneous fat to a subcutaneous muscle of the neck with single-step electrocoagulation of the transected vessels. Skin grafts are taken on three ligature holders on the upper and three ligature holders on the lower edges of the skin incision, pulled up and down, performed with an electric knife with a needle attachment dissection of subcutaneous fat from the subcutaneous muscle of the neck up to the level of the lower edge of the lower jaw, down to the level of the digastric muscle tendon, anterior to submaxillary salivary gland front edge, posterior to posterior edge of submaxillary salivary gland. Skin flaps are dilated with Farabeuf hooks upwards and downwards. Anatomical center of submandibular salivary gland is followed by disconnection of subcutaneous muscle of neck along its muscular fibers without their crossing to fascial box of submandibular salivary gland and from lower edge of lower jaw to level of a double-canopic muscle tendon. Edge of subcutaneous muscle in area of separation is lifted above fascial case and preparation of fascia from subcutaneous muscle is made within sizes of submandibular salivary gland forward and back. Edges of the prepared subcutaneous muscle are diluted with Farabeuf hooks, on an external plate of the fascial submandibular gland glandular fascial box visually define first edge branch of the facial nerve located below an edge of the lower jaw, and then a cervical branch of the facial nerve, between which a horizontal incision of an external plate of the submandibular fascial case is made from anterior to posterior edge of the submandibular salivary gland. Submandibular salivary gland is separated in a sharp and blunt manner from the walls of the fascial case from below upwards and backwards in front of musculus mylohyoideus, which is lifted by Farabeuf hook, visualises the lingual nerve, as well as a submandibular salivary gland duct, which is clamped, crossed, ligatured and removed. Submandibular salivary gland is removed from its bed. Posterior submandibular salivary gland is treated with 3 % hydrogen peroxide and then with 0.05 % aqueous chlorhexidine solution. Drainage is inserted, edges of subcutaneous muscle are brought together and fixed with 3 interrupted sutures Vicryl 5/0, subcutaneous fat is closed with interrupted sutures Vicryl 5/0, skin is closed with Prolen 6/0 intradermal suture.
EFFECT: method provides reliable dressing in manipulating the facial artery, preserving the marginal branch of the facial nerve and the lingual nerve, as well as eliminating the risk of developing complications accompanying the surgical removal of the new growth in the submandibular salivary gland.
4 cl, 3 ex
