| 摘要 |
FIELD: medicine. SUBSTANCE: method involves making an incision along nasolabial fold from mandible edge, along orbitoinferior boundary to zygomatic arch, then over auricle floor lobule base to nodding muscle, then in subcutaneous fat layer into submandibular area along inferior mandible edge. The incision is turned down on the planned width of facial defect. The incision is continued along the exterior jugular vein and clavicle. Skin flaps are separated to the subcutaneous muscle boundary. The subcutaneous muscle and jugular vein are transected near the clavicle and cut off together with external leaf of internal fascia from underlying tissues. The nodding muscle is deviated outwards in jugulosubdigastric area. Deep lymph nodes are included into the preparation to be removed. Submandibular lymph node group lymphodissection is carried out as a whole with external portion of submandibular salivary gland capsule. Parotid lymph nodes are excised as a whole with the parotid salivary gland capsule. Cheek skin and tissues are excised. Plastic repair of the so produced facial defect is carried out using submandibular cellulocutaneous flap. EFFECT: enhanced effectiveness of treatment; retained lymph nodes outside of the zone of interest; smaller scale of injuries. |
