METHOD FOR ELIMINATING DEFORMATION OF THE PAROTIDEOMASSETERIC REGION WITH A VASCULARISED FLAP OF SUPERFICIAL TEMPORAL FASCIA AFTER PAROTIDECTOMY Russian patent published in 2022 - IPC A61B17/00 A61B17/322 A61N1/18 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely, to maxillofacial, reconstructive, and plastic surgery. Marking is applied with a solution of brilliant green in the preauricular-postauricular, parieotemporal regions on the side of the lesion. Hydrotreatment of the soft tissues of the preauricular-postauricular region is then performed at the level of subcutaneous fat. A vertical preauricular incision is made along the top of the tragus to the lobe of the auricle, bordering the latter. The incision is continued to the mastoid region, descending along the hairline in the view of the anterior edge of the sternocleidomastoid muscle with a total incision length of up to 15 cm. The adipocutaneous flap is mobilised by the method for sharp and blunt dissection to the vertical border drawn from the lateral corner of the eye, corner of the mouth, anterior edge of the masseter muscle. The invasion of tumour nodules to the layer of superficial musculo-aponeurotic system of the face is visualised. The sheath of the sternocleidomastoid muscle is dissected. The posterior edge of the parotid gland is isolated and mobilised from the cartilaginous outer ear: the tragus and the intertragic notch. The trunk of the facial nerve is isolated. The parenchyma of the parotid gland is dissected above the trunk and the branches of the facial nerve: temporal, zygomatic, buccal, marginal, and cervical. The parotid gland and the tumour are resected depending on the localisation of the tumour, with resection of the flap of the superficial musculo-aponeurotic system SMAS. The branches of the facial nerve are then pulled back, the gland tissue under the facial nerve is isolated and removed together with the pharyngeal process in a block with the tumour. Then, after hydrotreatment of the soft tissues of the scalp in the parietotemporal region of the affected side, the initial anterior incision is extended in a Y shape into the parietotemporal region, with a total length of up to 10 cm. The adipocutaneous flaps are mobilised by blunt dissection to a width of up to 70 mm in the parietotemporal region. A 60 by 70 mm surface layer of the temporal fascia is isolated and cut on the feeding vessel a.temporalis superficialis using monopolar coagulation in the cutting mode. The flap is rotated 180 degrees towards the defect and secured along the perimeter of the wound with interrupted sutures. 3 to 4 drains made of silicone tubes are passed into the wound. The adipocutaneous flaps are put together in an anatomically correct position and secured with interrupted and blanket sutures.

EFFECT: possibility of eliminating a soft tissue defect of the parotideomasseteric region and isolating the trunk and branches of the facial and trifacial nerves without free tissue transfer and use of microsurgical equipment, preventing the occurrence of postoperative complications, achieving a high aesthetic result, and avoiding future corrective operations.

1 cl, 2 ex