Maxillary resection and orbital enucleation

Maxillary sinus cancer develops upwards, piercing the sacral wall of the eyelid and the periosteum has been eroded by the tumor. In addition to the removal of the maxilla, it is necessary to perform the sputum removal. Total maxillary removal of the maxillary maxillary total incision maxillary total incision incision plus inferior temporal margin incision of the upper lip to separate the anterior wall of the maxillary sinus, exposure of the piriform hole, nasal bone and infraorbital margin to cut the maxillary frontal process And the condyle cuts the hard palate mucosa from the nasal spine and cuts the hard palate to cut the maxillary nodule and the pterional process. After the maxilla was removed, the surgical cavity and cheek skin graft were filled with Vaseline gauze and iodoform gauze to suture the surgical incision. Treatment of diseases: maxillary sinus malignancy, maxillary sinus cancer Indication Maxillary sinus cancer develops upwards, piercing the sacral wall of the eyelid and the periosteum has been eroded by the tumor. In addition to the removal of the maxilla, it is necessary to perform the sputum removal. Contraindications Contraindications such as intraoperative infection, intraorbital infection, hemorrhagic shock, and tumor recurrence. Preoperative preparation 1. Should be used for x-ray film and nasal and sinus ct examination. Understand the extent of tumor invasion to determine the extent of surgical resection. 2. Preoperative preparation for general anesthesia. 3. Prepare blood. 4. Make the tray; cut off the hard palate and alveolar process due to surgery, in order to separate the oral cavity from the nasal cavity after surgery, it is easy to restore the chewing function. 5. Clean the mouth. Surgical procedure There is no eyelid erosion in maxillary sinus cancer, and sometimes it is difficult to judge correctly. Although the cranial ct examination can provide some evidence, it is sometimes necessary to explore the sacral wall during maxillary dissection to determine the sacral area. If the patella is found to have tumor erosion, the sacral content should be removed together with the maxilla. 1. The incision is made from the incision of the conventional maxillary dissection, starting from the internal malleolus, making a mouth along the upper and lower temporal margins, and merging in the lateral malleolus. 2. Open the flap and use scissors to separate the lower eyelid skin from the incision and open it with the cheek flap at the maxilla. The upper incision is then peeled off from the subcutaneous tissue with scissors to the upper edge of the iliac crest to fully expose the gingival margin. 3. Cut the periosteum to cut the periosteum along the upper edge of the iliac crest, and use the stripper to dissect the optic nerve hole outside the periosteum along the upper wall of the iliac crest. Leave the infraorbital margin connected to the maxilla and remove the maxilla. 4. First bend the vascular clamp from the posterior side of the eyeball. After clamping the optic nerve together with the blood vessel, cut the optic nerve with the optic nerve scissors, then turn the sputum content downward, and then perform the routine maxillary removal surgery. The content was removed with the maxilla and its tumor. 5. After removing the contents of the sputum and the maxilla, immediately stop the bleeding with hot saline gauze, and then ligature the tip of the iliac crest to stop bleeding. The pterygopalatine and its branches of the axillary fossa are then ligated. After cleaning the tumor tissue of the surgical cavity to the normal tissue, the electrocautery cavity is wound. 6. Block the surgical cavity, suture the incision with a gelatin sponge to cover the wound, and then cover a large vaseline gauze, and fill the cavity with iodoform gauze. The nasal incision was sutured after suturing the upper and lower eyelids. complication The ethmoid sinus should be taken as an x-ray film and a nasal and sinus ct examination. Understanding the extent of tumor invasion is immune to complications.