Holliday surgery

Treatment of diseases: neurofibromatoma meningioma Indication This procedure is suitable for the removal of lesions in the saddle, rock tip, upper slope, pterygopalatine and nasopharynx, such as squamous cell residual, meningioma, neurofibroma, osteoma, radioactive skull necrosis, rock tip bile Tumor, mucinous epithelial cancer, hemangioma, etc. Contraindications This procedure showed poor exposure to the internal carotid artery hole, the midline to the saddle, and the posterior to the pons cerebellum triangle. Preoperative preparation 1. Systemic and specialist examinations, including blood biochemistry, blood type, heart, lung, liver, kidney function, chest X-ray and paranasal sinus CT, MRI examination, if necessary, please consult the relevant departments, including neurosurgery, ophthalmology, etc. 2. Antibiotics were given 1 to 2 days before surgery and administered as required for general anesthesia. 3. Head preparation skin. Surgical procedure 1. Incision: The arc-shaped incision begins in the hairline of the ankle, and is bent backwards through the upper edge of the iliac crest. It extends horizontally on the zygomatic arch and extends to the front of the ear, and ends at the attachment of the earlobe. 2. Open the flap up and down to reveal the cellulite on the upper surface, the diaphragm of the diaphragm, the capsule of the upper parotid gland, or the frontal branch of the facial nerve. The sacral membrane was cut in 3 cm parallel to the zygomatic arch and 1 cm posterior to the iliac crest. Be careful not to damage the facial nerve. 3. Retract the diaphragm and facial nerve. The lower part of the anterior part of the diaphragm is pedicled, and the spare filling flap is made, which is separated from the bone surface and pulled downward. The posterior part of the diaphragm is cut below, and is pulled up after separation. Reveal the crotch. 4. Cut the zygomatic arch before and after, and connect it to the chewing muscle to turn down, separate the external muscles of the wing, and initially reveal the infraorbital fossa. The anterior lower part of the sphenoidal wing is ground to reveal the tip. 5. Use a power drill to grind the bones of the sphenoidal wing and the sacral scale. The front part can be left with an island for pulling the leaves. Further grinding off the foramen ovale, round hole and supracondylar bone, can reveal the supracondylar fissure and the parasagittal area. 6. Separate the temporomandibular joint and joint capsule, and pull it down to reveal the internal carotid artery, eustachian tube, and apex area. Dislocation of the temporomandibular joint revealed a scale rupture, and the sphenoid spinous process and the middle meningeal artery were found under the guidance of this cleavage. The keel of the posterior part of the spine is removed to better expose the internal carotid artery and the Eustachian tube. Continue to remove the bone around the internal carotid artery and the upper part of the rock tip, cut off the mandibular branch of the trigeminal nerve and the middle meningeal artery, remove the medial bone, reveal the eustachian tube, internal carotid artery and rupture hole. complication Ankle sag, facial numbness, loss of eustachian tube function, numbness of the forehead, and vocal sputum. Some are difficult to avoid, but the patient is still acceptable. Appropriate treatment can be given to reduce the extent of complications.