Temporal approach lacrimal gland excision

When the lacrimal gland tumor or chronic lacrimal gland inflammation is surgically removed, there are usually two paths, the temporal side path and the front path. Remove the giant lacrimal gland tumor and the particularly hypertrophic lacrimal gland, or the tumor volume is not too large, but extend to the back of the eyeball, you should choose the radial approach. This procedure is basically the same as krouml;nlein surgery in eyelid surgery. However, there are special requirements for the removal of the lacrimal gland. Treatment of diseases: lacrimal gland tumors, chronic lacrimal gland inflammation Indication Larger lacrimal gland tumors, chronic lacrimal gland inflammation, or tumors are not large, but are suspected of malignant transformation, requiring complete removal. Preoperative preparation 1. Preoperative preparation for anesthesia: general anesthesia. 2, surgical instruments: In addition to general equipment, should be prepared deep hook, periosteal separator, osteotome, hammer, bone pliers and so on. Surgical procedure 1. Stitching and splitting. Make a skin incision and cut the skin horizontally from the external malleolus to the temporal side. Then, an arc-shaped skin incision is made from the midpoint of the upper edge along the gingival margin to the temporal side, and the lateral incision is connected to the lateral incision. 2. Bluntly separate the orbicularis muscle in the incision. Use a hook to open the wound and stop bleeding, and expose the periosteum, septum and diaphragm of the diaphragm. On the periosteum in front of the outer edge of the iliac crest, the periosteum was cut at a distance of 2 mm from the gingival margin, and the length was 30 mm. Make a horizontal cut at each end. 3. Separate the periosteal membranes and expose the bone wall. The flat bone chisel and the hammer are used to cut off the thick bone wall of the upper and lower ends of the gingival margin, and the thin bone wall of the posterior part is cut off by the sputum and the outer corner of the lower iliac cleft. 4. Broken the bone piece and push it to the temporal side. The periosteum was dissected and isolated, and the tumor was exposed from the periosteal incision. 5. Use the periosteal separator to separate the periosteum from the upper and lower parts of the periosteum, free the lacrimal gland and extract the incision. 6. Pull open the levator levator, separate the relationship between the temporal lobe and the aponeurosis, free the lacrimal gland, and pull out the incision. The lacrimal gland was removed after ligation of the stalk of the lacrimal gland. 7. Suture the periosteum of the face, restore the bone piece, suture the front periosteum and the rim rim muscle. 8. Suture the skin with a 3-0 suture and gently bandage with a bandage. 9. The removed lacrimal gland should be examined for pathology. complication Common complications are incomplete tumor removal and injury to the levator levator. If the tumor is not completely removed, remedial measures should be taken after the pathological results are reported, and surgery should be performed if necessary. When the ptosis occurs, the mild person does not get in the way, and the severe ptosis can be used for corrective surgery.