Partial lacrimal gland resection

The lacrimal gland is located in the lacrimal gland outside the eyelid and is separated into a larger ankle and a smaller lacrimal gland by the upper levator iliac crest. The drainage tube is about 10 to 20, and the opening is in the upper epithelial conjunctiva. Clinically, lacrimal gland prolapse is more common. Lacrimal gland prolapse refers to the lacrimal gland leaving the lacrimal gland and prolapsed to the front or below. The disease is easily overlooked. Can be divided into primary and secondary. The former is the congenital lacrimal gland dislocation, which is common in women aged 14 to 24 years old, and may be related to heredity. The latter is more common in the elderly and those with loose eyelids. It can also occur in eyelid fractures caused by blunt eye. Diagnostic points: 1 elderly patients, mostly with eyelid relaxation. The lacrimal gland is protuberance or sagging, and the lacrimal gland is visible when the upper eyelid is pulled up. 2 young patients, the upper side of the upper swell is swollen, like a tumor, often bilaterally symmetrical, no pain and tenderness. 3 The bulge can be incorporated into the sputum, but it is released after releasing the hand. Traumatic lacrimal gland prolapse is mostly caused by mechanical trauma or accidental warfare. The prolapsed lacrimal gland tissue is mostly normal tissue. They all have normal secretion function, so it is necessary to take appropriate reduction surgery. The effect is better than resection. It is better to reset the technique. Treatment of diseases: lacrimal adenocarcinoma Indication Partial lacrimal gland resection is applicable to: lacrimal gland prolapse. Contraindications Lacrimal gland inflammation. Preoperative preparation It is best to shave the patient's eyebrows. Surgical procedure 1. Skin incision A slightly curved incision is made on the temporal side of the lower part of the eyebrow arch to the temporal side. 2. Cut the orbicularis muscle to separate the subcutaneous tissue, cut the orbicularis muscle, pay attention not to damage the levator levator muscle fiber, and gradually separate the orbicularis muscle to the septum. 3. Exposing the septum apart from the orbicularis muscle layer, you can see a strong elastic distribution between the iliac crest and the iliac crest. A little pressure on the inside of the sputum, you can see the lacrimal gland of the prolapse from the weak relaxation of the ridge. 4. Excision of the lacrimal gland and fat at the highest point of prolapse, parallel to the gingival margin to cut the septum, the general length of cut is about 1.5cm, it is best to make a marking line when cutting, for later search. Gently separate the septum so that the prolapsed lacrimal gland and edema fat are naturally removed and excised. The amount of lacrimal gland resection depends on the degree of prolapse, and should generally not exceed 1/2 of the lacrimal gland. 5. Reinforce the septum to overlap the incision, so that the upper lip is on the lower part and the lower lip is on the upper part. Tighten the 3~5-needle type suture, and if necessary, fix the lower lip to the periosteum of the outer edge of the ankle. . Then, the orbicularis muscles are overlapped with each other to make a 3 to 5 needle-type suture, and the width of the suture depends on the degree of relaxation of the septum. In short, it is better to achieve both the reinforcement of the septum and the closure of the eyelids. The skin is sutured intermittently. 6. Excision of the loose skin removes part of the skin according to the degree of skin relaxation to eliminate the arcuate drooping fold formed by the lacrimal gland prolapse. Finally, a 3-needle double quilting line can be made at the rim of the rim to facilitate aesthetics.