Хирургия головы и шеи - Rzayev Rafik ч2
Ринопластика
Планирование ринопластики основано на анализе внешности и психологического статуса пациента и предполагает следующие шаги: определение целей пациента, оценка его внешности с эстетических и анатомических позиций, составление начального плана операции, фотоанализ и оценка альтернатив, окончательная доработка плана вмешательства.
Врожденный околоушный свищ
Врожденные околоушные свищи развиваются вследствие нарушений развития эмбриональных зачатков наружных отделов первой жаберной дуги и проявляются в виде точечного входного (выводного) отверстия, располагающегося спереди и чуть ниже козелка или спереди от него.
Лечение околоушного свища только хирургическое.
Ринопластика (открытый чресколонный доступ)
Каждая деформация, каждый даже незначительный дефект на лице требует устранения. Однако такая упрощенная установка, если не подходит к больному индивидуально, может нанести ему вред.
Операции в области носа являются одними из самых популярных и самых трудных эстетических вмешательств. Оптимальным возрастом для проведения эстетической ринопластики является 18-25 лет.
Остеогенная фиброма носовой полости
A 45-year-old man presented with an ossifying fibroma of the nasal cavity with involving the maxillary, ethmoid and sphenoid sinuses, which also penetrated intracranial. The tumor was successfully excised applying operation-anterior craniofacial resection.
Языковая гипертрофия миндалин
The basic morphological substratum at the majority of patients with symptoms such as sore throat, globus sensation, speech change or dysphagia and a condition a «fright in eyes», is elementary mechanical contact of edge hypoglottic with own lingual tonsil which sometimes is exposed hypertrophy.
Carcinoma ex pleomorhic adenoma
A 42-year-old female with a history of a left parotid mass for 10 years presented with a recent rapid growth of the mass. Subsequent fine-needle aspiration biopsy of the mass rendered a «suspicious for malignancy» diagnosis. A computerized tomography scan showed a 5 cm mass in the left superficial lobe of the parotid gland. There was no evidence of metastatic disease either by computerized tomography scan or magnetic resonance imaging. It is made excision of parotid gland tumor with conservation of the facial nerve.
The histopathologi conclusion: myoepitelial carcinoma ex pleomorphic adenoma.
Носовой полип
Angiomatous nasal polips — rather seldom arisen pseudoneoplastic lesions, which diagnostics owing to them pathophysiological features it can sometimes appear problematic. At the patient discussed in this clip, presence of aggressively growing tumor in nasal cavity was clinically supposed. Unpersuasive histological data preoperative biopsy did not exclude possibility of vascular neoplasm, including and presence of a malignant lesions at the patient. On it, depending on the possible finds, to peculiar tumors, the plan of operation did not exclude expanded intervention.
Meanwhile, intraoperative the finds testifying in advantage benign of process (an atrophy surrounding tissues, fibro-vascular parenchyma and capsule presence — pseudocapsule, absence of the bone invasion and destruction) have allowed, will be limited to sparing operation.
Карцинома глоточного отростка ОСЖ
Актуальность проблемы позволяет нам выдвинуть гипотезу, о возможной эффективности сохранения поверхностной доли околоушной слюнной железы при удалении некоторых опухолей ее глоточного отростка. Одним из предпосылок к этому служит, то что, щадящее вмешательство на паренхиме железы, обеспечивая адекватный подход к опухоли, позволит устранить опасности повреждения, как лицевого нерва, так и секреторных волокон (вызывающее вегетативные расстройства в околоушной области), идущих к околоушной железе, а также сохранить архитектонику околоушной области.
Коллапс носового клапана
Among persons with nasal obstruction in 13 % that is promoted by presence of a collapse of the nasal valve. Frequently to development of the given pathology can promote rhinoplasty (79 %), a trauma (15 %) and congenital anomaly of the nose (6 %). For elimination of the having defects which are the reason nasal obstruction in this case, it has been made opened rhinoseptoplasty. Septoplasty at the first stage of operation has allowed to make simultaneously correction of structures nasal cavity, and also to eliminate presence of collapse of the external and internal nasal valve at the second stage by means of transplants from septal cartilage the patient.
Киста околоушной слюнной железы
Parotid Cyst. The patient (age of 25 years) has addressed to us with complaints to swelling presence in parotid areas on the right. At palpation it is defined motionless the roundish form a swelling, having a soft consistence without painful sensations. With suspicion on parotid the tumor has been made МRI which diagnosed presence parotid cyst, which has allowed to estimate also the sizes and to specify defeat topography. At a puncture of a cyst the muddy liquid with mucus has been received — cellular elements are not found out. Operation — cystectomy, is made with carrying out of a typical cut as at parotydectomy. Removal parotid cysts sometimes represents certain difficulties because of a thin cover and possible mutual relation cyst with branches facial nerve, which damage will inevitably lead palsy mimic muscles and to half distortion face. It is necessary to underline also, that remain cover parts cyst as usually promotes to relapse.
Планирование ринопластики основано на анализе внешности и психологического статуса пациента и предполагает следующие шаги: определение целей пациента, оценка его внешности с эстетических и анатомических позиций, составление начального плана операции, фотоанализ и оценка альтернатив, окончательная доработка плана вмешательства.
Врожденный околоушный свищ
Врожденные околоушные свищи развиваются вследствие нарушений развития эмбриональных зачатков наружных отделов первой жаберной дуги и проявляются в виде точечного входного (выводного) отверстия, располагающегося спереди и чуть ниже козелка или спереди от него.
Лечение околоушного свища только хирургическое.
Ринопластика (открытый чресколонный доступ)
Каждая деформация, каждый даже незначительный дефект на лице требует устранения. Однако такая упрощенная установка, если не подходит к больному индивидуально, может нанести ему вред.
Операции в области носа являются одними из самых популярных и самых трудных эстетических вмешательств. Оптимальным возрастом для проведения эстетической ринопластики является 18-25 лет.
Остеогенная фиброма носовой полости
A 45-year-old man presented with an ossifying fibroma of the nasal cavity with involving the maxillary, ethmoid and sphenoid sinuses, which also penetrated intracranial. The tumor was successfully excised applying operation-anterior craniofacial resection.
Языковая гипертрофия миндалин
The basic morphological substratum at the majority of patients with symptoms such as sore throat, globus sensation, speech change or dysphagia and a condition a «fright in eyes», is elementary mechanical contact of edge hypoglottic with own lingual tonsil which sometimes is exposed hypertrophy.
Carcinoma ex pleomorhic adenoma
A 42-year-old female with a history of a left parotid mass for 10 years presented with a recent rapid growth of the mass. Subsequent fine-needle aspiration biopsy of the mass rendered a «suspicious for malignancy» diagnosis. A computerized tomography scan showed a 5 cm mass in the left superficial lobe of the parotid gland. There was no evidence of metastatic disease either by computerized tomography scan or magnetic resonance imaging. It is made excision of parotid gland tumor with conservation of the facial nerve.
The histopathologi conclusion: myoepitelial carcinoma ex pleomorphic adenoma.
Носовой полип
Angiomatous nasal polips — rather seldom arisen pseudoneoplastic lesions, which diagnostics owing to them pathophysiological features it can sometimes appear problematic. At the patient discussed in this clip, presence of aggressively growing tumor in nasal cavity was clinically supposed. Unpersuasive histological data preoperative biopsy did not exclude possibility of vascular neoplasm, including and presence of a malignant lesions at the patient. On it, depending on the possible finds, to peculiar tumors, the plan of operation did not exclude expanded intervention.
Meanwhile, intraoperative the finds testifying in advantage benign of process (an atrophy surrounding tissues, fibro-vascular parenchyma and capsule presence — pseudocapsule, absence of the bone invasion and destruction) have allowed, will be limited to sparing operation.
Карцинома глоточного отростка ОСЖ
Актуальность проблемы позволяет нам выдвинуть гипотезу, о возможной эффективности сохранения поверхностной доли околоушной слюнной железы при удалении некоторых опухолей ее глоточного отростка. Одним из предпосылок к этому служит, то что, щадящее вмешательство на паренхиме железы, обеспечивая адекватный подход к опухоли, позволит устранить опасности повреждения, как лицевого нерва, так и секреторных волокон (вызывающее вегетативные расстройства в околоушной области), идущих к околоушной железе, а также сохранить архитектонику околоушной области.
Коллапс носового клапана
Among persons with nasal obstruction in 13 % that is promoted by presence of a collapse of the nasal valve. Frequently to development of the given pathology can promote rhinoplasty (79 %), a trauma (15 %) and congenital anomaly of the nose (6 %). For elimination of the having defects which are the reason nasal obstruction in this case, it has been made opened rhinoseptoplasty. Septoplasty at the first stage of operation has allowed to make simultaneously correction of structures nasal cavity, and also to eliminate presence of collapse of the external and internal nasal valve at the second stage by means of transplants from septal cartilage the patient.
Киста околоушной слюнной железы
Parotid Cyst. The patient (age of 25 years) has addressed to us with complaints to swelling presence in parotid areas on the right. At palpation it is defined motionless the roundish form a swelling, having a soft consistence without painful sensations. With suspicion on parotid the tumor has been made МRI which diagnosed presence parotid cyst, which has allowed to estimate also the sizes and to specify defeat topography. At a puncture of a cyst the muddy liquid with mucus has been received — cellular elements are not found out. Operation — cystectomy, is made with carrying out of a typical cut as at parotydectomy. Removal parotid cysts sometimes represents certain difficulties because of a thin cover and possible mutual relation cyst with branches facial nerve, which damage will inevitably lead palsy mimic muscles and to half distortion face. It is necessary to underline also, that remain cover parts cyst as usually promotes to relapse.
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