Reconstruction post oncologic maxillectomy. IPRASRicardo Yanez
油
This study presents the reconstructive options used in 12 patients who underwent maxillectomy for cancer treatment. The patients underwent maxillectomy types I-IV and reconstruction included obturator prosthesis, local temporalis muscle flap, or free radial forearm or latissimus dorsi flaps. Outcomes were satisfactory functionally, though two patients developed pneumonia and one had partial flap necrosis. The study concludes that reconstructive choice should consider maxillectomy type, age, cancer stage and comorbidities, with obturator prosthesis reserved for limited defects and microsurgery preferred for types II-IV to achieve best function and aesthetics.
Reconstruction post oncologic maxillectomy. IPRASRicardo Yanez
油
This study presents the reconstructive options used in 12 patients who underwent maxillectomy for cancer treatment. The patients underwent maxillectomy types I-IV and reconstruction included obturator prosthesis, local temporalis muscle flap, or free radial forearm or latissimus dorsi flaps. Outcomes were satisfactory functionally, though two patients developed pneumonia and one had partial flap necrosis. The study concludes that reconstructive choice should consider maxillectomy type, age, cancer stage and comorbidities, with obturator prosthesis reserved for limited defects and microsurgery preferred for types II-IV to achieve best function and aesthetics.
This document provides an outline of the anatomy, examination, and surgical procedures involved in rhinoplasty. It begins with a description of the skin, muscles, blood supply, innervation, and bony and cartilaginous structures of the nose. Assessment of the nasal valves, septum, and turbinates is described. Basic aesthetic parameters and common anatomic variants are discussed. The document concludes with descriptions of routine surgical steps like incision, skin dissection, grafting techniques, and areas commonly augmented like the radix, spreader grafts, and tip grafting.
Salivary glands 1 /certified fixed orthodontic courses by Indian dental academy Indian dental academy
油
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
A maxillectomy is the surgical removal of part or all of the maxilla bone in the upper jaw. The document describes a partial anterior maxillectomy procedure performed to remove cancerous tissue from the front part of the patient's hard palate. An obturator was fitted to seal the opening between the mouth and nose caused by the maxilla removal. Risks of the surgery include bleeding, infection, and possible nerve damage. Future problems may include issues with speech, swallowing, pain, infection, and eating/drinking.
Total maxillectomy is a surgical procedure to remove the entire maxilla bone. It was first described in the 1820s and approaches have been refined over time. It is indicated for malignant tumors involving the maxilla, extensive benign tumors, or fungal/granulomatous infections. Contraindications include poor general health, bilateral orbital involvement, or skull base extension. Potential complications include bleeding, infection, epiphora, skin graft breakdown, numbness, and atrophic rhinitis. Careful surgical planning and follow up are required due to significant reconstruction and rehabilitation needs.
Sialolithiasis and its management in oral and maxillofacial surgeryArjun Shenoy
油
Sialolithiasis refers to calcified structures that develop within the salivary glands or ductal system. The document discusses the pathogenesis, diagnosis and treatment of sialolithiasis. It notes that 80-92% of sialoliths occur in the submandibular gland, which has an abundant calcium concentration and alkaline pH that promotes stone formation. Diagnosis involves imaging like sialography, ultrasound or CT scan to detect radiopaque stones. Treatment options include surgical removal of stones, sialoendoscopy or shockwave lithotripsy depending on the size and location of the sialolith.
The submandibular gland is a major salivary gland located in the submandibular region under the mandible. It develops from endodermal buds in the floor of the mouth and grows posteriorly lateral to the tongue. The gland has both superficial and deep parts divided by the mylohyoid muscle. It is a branched tubuloacinar gland composed of serous and mucous acini that secrete saliva. The submandibular gland duct, called Wharton's duct, emerges from the deep part of the gland and opens on the floor of the mouth. The gland is supplied by the facial artery and drains into submandibular lymph nodes.
Classifications of salivary glands diseasesa7med2101
油
The document classifies diseases of the salivary glands into 5 categories: 1) reactive lesions, 2) infectious sialadenitis, 3) benign neoplasms, 4) malignant neoplasms, and 5) rare tumors. It provides examples and descriptions of conditions for each category. Necrotizing sialometaplasia, a benign condition mimicking malignancy, typically affects the palate and presents clinically as swelling, erythema, tenderness and ulceration in the junction of the hard and soft palates.
This document describes the anatomy of several muscles and structures in the submandibular region. It includes descriptions and images of the digastric muscle, myelohyoid muscle, hyoglossus muscle, geniohyoid muscle, genioglossus muscle, stylohyoid muscle, submandibular gland, sublingual gland, and the submandibular ganglion. Relations and functions of each structure are provided, with an emphasis on their location and connections to surrounding muscles and nerves in the neck.
This document discusses diseases of the salivary glands. It begins by identifying the major salivary glands as the parotid, submandibular, and sublingual glands. It then discusses various diseases including developmental anomalies, sialadenitis (inflammatory disorders), obstructions, Sj旦gren's syndrome (an autoimmune disease causing dry mouth and eyes), sialadenosis (recurrent swelling), and HIV-associated salivary gland disease. For many of these diseases, it provides details on causes, clinical features, histopathology, and investigations. In summary, it provides an overview of the major diseases that can affect the salivary glands.
The document discusses various salivary gland diseases including functional disorders like sialorrhea and xerostomia, obstructive disorders like sialolithiasis, non-neoplastic disorders such as acute and chronic sialadenitis, and neoplastic disorders including adenomas, mucoepidermoid tumors, carcinomas, and malignant lymphomas. It also covers sinus diseases such as acute and chronic sinusitis, their causes, symptoms, treatments, and potential complications.
This document provides information on salivary gland diseases presented over multiple sessions. It begins with the objectives and overview of topics to be covered, including applied anatomy of the salivary glands, autonomic innervation and effects on function, inflammatory and obstructive disorders, neoplasms, and investigations. It then describes in detail the anatomy, physiology and investigations of the major salivary glands. Salivary gland diseases are classified as functional, obstructive, non-neoplastic and neoplastic. Specific conditions like sialadenitis, sialolithiasis, mucocele and ranula are explained. Imaging modalities like ultrasound, sialography, CT, MRI and sialendoscopy
The document summarizes the anatomy of the salivary glands. It describes the locations and relations of the major salivary glands: the parotid gland is the largest salivary gland located in the preauricular region, the submandibular gland is inferior to the mandible, and the sublingual gland is beneath the floor of the mouth. It also discusses the minor salivary glands distributed in the oral mucosa, and the innervation and blood supply of the major salivary glands.
Vestib端ler schwannoma varl脹脹nda petrous kemik anatomisindeki topografik deiiklikler ve retrosigmoid transmeatal yakla脹ma etkileri
Transmeatal drilling(oymak-delmek) ilemi erken veya ge巽 iitme kayb脹na yol a巽abilecek olan i巽 kulak yap脹lar脹na hasar verme riski ta脹r.
al脹man脹n amac脹 t端m旦r端n petrous kemik anatomisinde yapt脹脹 deiiklikleri tan脹mlamak ve endolenfatik sistem hasar脹n脹n hem risk hem de insidans脹n脹 analiz etmek.
Bu prospektif 巽al脹maya vestib端ler schwannoma ameliyat脹 olmu 100 hasta dahil edildi. Ameliyat 旦ncesi ve sonras脹 bilgisayarl脹 tomografi uyguland脹 ve hem patolojik hem sal脹kl脹 alanlar脹n topografik 旦l巽端leri deerlendirildi. Postoperatif anatomik ve fonksiyonel deerler 旦l巽端ld端.
Sonu巽larda i巽 kulak yolunun 巽ap脹 petrous kemiin etkilenen alanlar脹nda kar脹 taraftaki sal脹kl脹 alanlara g旦re daha b端y端kt端. Vestib端ler kanal脹n hasar oran脹 artan t端m旦r b端y端kl端端 ile beraber artt脹.
2. Ballenger's ORL HNS
Lore J. M. An Atlas of HNS
Bailey B.J. ORL HNS
Myers - Operative Otolaryngology
Cummings Otolaryngology HNS
nerci M. Temel Cerrahi Teknikler
Huizing E.H. Functional Reconstructive Nasal
Surgery
Glasscock - Shambaugh Surgery Of The Ear
ak脹r N. Otolaringoloji BBC
Janfaza Surgical Anatomy of the Head and Neck
3. 聴nsizyon, skar
dokusu 巽izgiler
端zerinde/paralel
Dik yap脹l脹rsa - yara
dudaklar脹 巽ekilmesi
- k旦t端 skar
K脹r脹脹kl脹klar -
genelde bu
巽izgilere paralel
4. Boyun diseksiyonu insizyonlar脹
Dier boyun insizyonlar脹
Kulak cerrahisi insizyonlar脹
Septoplasti Rinoplasti insizyonlar脹
Paranazal sin端slere yakla脹m insizyonlar脹
5. IA: digastrik 旦n
kar脹nlar脹-hyoid
IB: digastrik 旦n ve arka
karn脹
II: kafa kaidesi- karotis
bifurkasyonu/hyoid
IIA-IIB: spinal aksesuar
sinir
III:karotis
bifurkasyonu/hyoid
- omohyoid/krikoid
6. IV: omohyoid/krikoid-
klavikula
V: SCM- trapez
klavikula
VA VB: krikoid alt
s脹n脹r脹
VI: hyoid- suprasternal
巽entik- karotis k脹l脹flar脹
7. Mandibulaya horizontal insizyon 4cm
inferiordan
- marjinal mandib端ler
- 巽izginin alt ve 端st k脹sm脹 farkl脹 arterlerden
beslenir
聴nsizyonlar脹n kesitii b旦lge karotisten uzak
olmal脹
Yeterli g旦r端
Kozmetik sonu巽lar
Preoperatif RT/postoperatif RT olas脹l脹脹
8. Primer lezyonun lokalizasyonu
Rekonstr端ksiyon prosed端rleri
Lenfadenopatinin yeri/ tek veya 巽ift tarafl脹
oluu
Fleplerin yaamsall脹脹
nceki skarlar
Kiisel deneyim
9. Ayn脹 taraf mastoid-
krikoid inferioru- kar脹
taraf hyoid b端y端k
boynuzu
Boynun 端st ve alt
k脹sm脹na m端kemmel
ekspozisyon
st flebde persistan
旦dem(旦zellikle RT
alanlarda)
Kanlanmas脹 a.facialis
10. Avantaj
- boyun 端st k脹sm脹,
mandibula iyi
ekspozisyonu
- 巽eneye/alt dudaa
uzat脹labilmesi
- orta hat
madibulotomiyle
kombine edilebilmesi
11. Dezavantaj
- 端巽l端 insizyon olmas脹
(yarada a巽脹lma)
- boyun alt b旦lge
ekspozisyonunun zor
olmas脹
12. Daha 巽ok tarihi 旦nem
Yap脹lar iyi ekspoze olur
Fleplerin keskin
trifurkasyonu
Superior trifurkasyon
y脹k脹l脹rsa karotis k旦t端
korunur
Posterior flep serbest
kenar脹nda k旦t端
kanlanma/nekroz eilimi
(serbest kenardan 0.5-1
cm eksizyon)
Kozmetik sorunlar
13. Karotis iyi
ekspozisyon/koruma
Dik a巽脹l脹 vertikal
insizyon
(akut a巽脹l脹 nekroz
ihtimali)
Boyun orta b旦lgesinde
daha az skar
Flebin posterior-
superior ucunun az
kanlanmas脹
SCM alt ucunun iyi
olmayan ekspozisyonu
14. Schobinger ins.
modifikasyonu (flebinin
post.-super. ucunun
yaam脹n脹 art脹rmak)
Horizontal 端st ayak vertikal
alt ayakla devam eder
Posterosuperior flebde 端巽l端
insizyon
Anteroinferior
ekspozisyonun iyi
olmamas脹
15. ift transvers insizyon
聴yi kozmetik sonu巽
Alt k脹s脹m diseksiyon
端st insizyonla yap脹l脹r
Zor diseksiyon
Merkezi segmentin
kanlanmas脹n脹n iyi
olmamas脹
(旦zellikle RT alm脹
hastalarda)
16. II-V b旦lgelerin ortaya
konulmas脹
Mastoid apeks - arka
端巽gen klavikula 3cm
端zerinden keskin
d旦n端
Gerekirse bilateral
diseksiyon i巽in kar脹ya
uzat脹lmas脹
Kanlanmas脹 a. facialis
31. Horizontal
insizyona ilave
olarak SCM 旦n
kenar脹 boyunca
vertikal insizyon
Karotise ula脹m
32. Boyun diseksiyonu insizyonlar脹
Dier boyun insizyonlar脹
Kulak cerrahisi insizyonlar脹
Septoplasti Rinoplasti insizyonlar脹
Paranazal sin端slere yakla脹m insizyonlar脹
33. 掘姻庄一庄稼糸艶 ocukta
2 ya脹n alt脹nda daha arkadan fasyal sinir!
34. DKY kemik
k脹k脹rdak birleim
yeri
Arka duvar boyunca
yukar脹 uzat脹l脹r
st ucu tragus ve
heliks aras脹ndan
35. DKY卒 ye
yerletirilmi
spekulum yard脹m脹
ile
Anulus lateralinden
12 hizas脹ndan kavis
yaparak 6 hizas脹na
doru
36. DKY hizas脹nda
aurikulan脹n 3 cm
端zerinden balar
Postaurik端ler
sulkusun 4-5 cm
arkas脹ndan
Mastoid tipin 1.5
cm inferioruna
kadar
37. Tragusun 1 parmak
旦n端nde zigoma
hizas脹ndan
Aurikulan脹n
posterioruna d旦ner
st k脹sm脹 zigoman脹n 8
cm superiorunda
olacak ekilde soru
iaretine benzer
38. Postaurik端ler
sulkusun 7 cm
arkas脹ndan
Akustik n旦rom,
vask端ler
dekompresyon
cerrahisi
42. Boyun diseksiyonu insizyonlar脹
Dier boyun insizyonlar脹
Kulak cerrahisi insizyonlar脹
Septoplasti Rinoplasti insizyonlar脹
Paranazal sin端slere yakla脹m insizyonlar脹
43. Kartilajin旦z septumun
hemen 旦n端nde
membran旦z septumdan
ge巽er
Kolumella retraksiyonu,
tip d端端kl端端
Septuma yakla脹m
a巽脹s脹ndan yerini
hemitransfiksiyon alm脹t脹r
Son zamanlarda 旦nemini
tekrar kazanm脹t脹r
(degloving)
47. Lateral krus, dom
ve medial krusun
kaudalinden
Alar kartilajlara ve
doma eriim
48. Alar kartilaj lateral
krusundan
Alar kartilaja eriim
Lateral krus ve dom
modifikasyonlar脹
49. Kolumellan脹n alt 1/3
Horizontal ters V
A巽脹k yakla脹mda
bilateral
infrakartilajin旦z ile
kombine edilir
Alar kartilajlar, dorsum,
anterior septuma geni
eriim
聴nsizyon skar脹
50. Boyun diseksiyonu insizyonlar脹
Dier boyun insizyonlar脹
Kulak cerrahisi insizyonlar脹
Septoplasti Rinoplasti insizyonlar脹
Paranazal sin端slere yakla脹m insizyonlar脹
51. Ka脹n medyal y端z端n端n
alt脹ndan balayan i巽
kantus ve nasion aras脹
mesafenin ortas脹ndan
devam eden alar
sulkus i巽ine giren
n nazal kavite, komu
maksilla, etmoid
sin端slerin medyal 1/3
lezyonlar脹
