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| Name | Submandibular salivary gland excision |
| Video Uploader | Video From KONSTANTINOS APOSTOLOPOULOS |
| Upload Date | This Video Uploaded At 08-03-2019 05:33:52 |
| Video Discription | Submandibular gland excision For benign tumors and chronic infections of the gland Patient With Chronic Sieladenitis Of the Submandibular Gland General anesthesia with an oral endotracheal tube is delivered. The head is overextended with a pillow placed under the shoulders We raise the bed 30 degrees to a reverse Trendelenburg position. The head is turned to the opposite side of the lesion I initially mark the angle of the mandible.... ...and I design the entire length of the lower edge of the body of the mandible I also mark with a dotted line the course of the submandibular ramus of the facial nerve. I place the incision 3-4 cm below this line The incision line extends 5 cm long I place 4 Lahey forceps to the subcutaneous tissue and I pull up the flaps I prepare the platysma, superiorly and inferiorly for 2-3 cm This should be done cautiously, because the platysma must be used as a surgical landmark for this kind of surgery So from the beginning, I consciously prepare the platysma and clearly identify it Though time-consuming, I consider this step of the outmost importance for the nerve's salvage I incise the platysma as atraumatically as possible I cut the superficial layer of the deep neck fascia Notice that I pull the platysma upwards atraumatically, with two insulin syringes which I use as retractors (after pertinent adaptation) As I pull upwards the identified neck fascia, I take with it the nerve as well because I know that it is contained in this envelope ....and inside this envelope between the platysma and the fascia the nerve is safe I prepare and ligate the anterior facial vessels and I keep the ligation also as a landmark. The gland is dissected from the posterior belly of the digastric muscle The fascial attachments from the gland to the free border of the mandible are bluntly divided to expose the free border of the mandible. Facial artery ligation The anterior belly and the intermediate tendon of the digastric muscle A Langenberg retractor is placed under the free border of the mylohyoid and pulls the muscle anteriorly while the gland is retracted posteriorly The gland is retracted inferiorlly with a sponge to visualize the lingual nerve which forms a V shape. ....and is dissected free from the gland at the area of the submandibular gagglion Now I prepare the submandibular duct towards the mouth Which in this case has purulent inflamation I prepare the duct as high as possible after bimanual palpation of Warthon's duct Before the final cut on the gland I must identify the hypoglossal nerve |
| Category | Science & Technology |
| Tags | salivary gland stones | chronic sialadenitis | submandibular gland lithiasis | inflammation of salivary gland |
