SURGERY TECHNIQUE FOR DIFFUSE PHLEGMONS OF CELLULAR SPACES ADJOINING TO MANDIBLE RAMUS

摘要

FIELD: medicine; dentistry.;SUBSTANCE: skin is dissected in retromandibular region between leading edge of bowing muscle and trailing edge of mandible ramus anteriad to back edge of submandibular gland at the distance 3.0 cm upwards and 1.5-2.0 cm downwards from a conditional point of mandibular angle on superior nuchal fold. Posteroinferior parotid gland along with a capsule is cut off from leading edge of bowing muscle and from submandibular gland with attachment of submandibular gland to bottom edge of mandible completely maintained. Posteroinferior parotid gland is displaced up anteriad, and posterior submandibular gland is displaced down anteriad. Trailing edge of mandible ramus is uncovered. Fascia of parotid gland is dissected on trailing edge of mandible ramus. Tendons of mastication muscle are cut off in length up to 8-10 mm at masseteric tuberosity of mandible. Mastication muscle is displaced anteriad and entoectad. Tendon of medial pterygoid muscle is dissected on internal trailing edge of mandible ramus in length 10-15 mm at pterygoid tuberosity of mandible. Medial pterygoid muscle is displaced inward. Submastication, pterygomandibular, anterior and posterior peripharyngeal spaces are inspected with evacuation of purulent discharge, antiseptic processing and drainage of a purulent wound.;EFFECT: reduced risk of injuring marginal branch of facial nerve, developing of postoperative contracture, provided rapid wound cleansing.;2 ex, 7 dwg, 1 tbl