METHOD FOR REMOVAL OF PLEOMORPHIC ADENOMA OF PAROTID SALIVARY GLAND Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial, aesthetic surgery, oncology. Skin is marked horizontally along the edge of the hair growth zone of the temporal region, continued through the apex of the tragus, bordering the earlobe, passing into the behind-the-ear region and turning on the neck in the region of the anterior edge of the sternocleidomastoid muscle. Line is marked 3 cm outwards from the lower edge of the palpebral fissure, 5 cm outwards and parallel to the nasolabial fold, inwards from the angle of the lower jaw. Skin and subcutaneous fat are incised. Superficial muscular-aponeurotic system is dissected. In a layer between a superficial musculo-aponeurotic system and a parotid-masticatory fascia, an adipocutaneous flap is detached to an anterior edge of a parotid salivary gland. Greater auricular nerve is visualized along the posterior surface of the sternocleidomastoid muscle. It is mobilized and lateralized. Parotid salivary gland fascia is dissected vertically. Along the course of the cartilaginous and bone parts of the external auditory meatus, dissection is performed with the help of bipolar forceps of soft tissues towards the stylomastoid foramen. Facial nerve trunk is visualized. Detachment of a superficial lobe of the parotid salivary gland with a new growth in the planes of the branches of the facial nerve is performed bluntly. Neurolysis of facial nerve branches is performed. Greater and lesser zygomatic muscles, the fatty body of the cheek, the buccal and zygomatic branches of the facial nerve are visualized. Neurolysis of the above branches is performed in the direction from the periphery to the level of origin of the facial nerve trunk. Superficial lobe of the parotid salivary gland is removed together with the new growth. Masticatory muscle is visualized in the space between the buccal and zygomatic branches and retrogradely mobilized from the lower jaw. Temporal muscle tendon is visualized. Tendon of the temporal muscle is cut off from the coronoid process of the lower jaw. Osteotomy of a coronal process of the lower jaw is performed from a notch of the lower jaw along a tangent to an external oblique line. Sialoadenectomy is performed. Facial vessels are moved laterally, the hyoid nerve is visualized and moved aside. Styloid process is resected. Styloglossus, stylohyoid, stylopharyngeus muscles are cut off from the styloid process with the help of Liston nippers. Postoperative wound is drained with active drains. Tissues are closed in layers, and the skin is closed with an intradermal suture.

EFFECT: method enables to provide access during the surgical treatment of pleomorphic adenoma of the parotid salivary gland without damaging the nerve fibers of the greater auricular and facial nerves, preserve functional state of neck and face musculature, hard tissues, solve problem of aesthetics and functional state of maxillofacial area in remote postoperative period, reduce rehabilitation period.

1 cl, 1 ex