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Application of endoscopic technique in maxillofacial and neck

Released on Apr. 19, 2022

Minimally invasive technology is the trend of today's surgery. The application of endoscope in plastic surgery is more and more popular, such as wrinkle surgery, breast augmentation surgery, abdominal plastic surgery, underarm body odor surgery, maxillofacial and neck surgery, etc. Can be performed with the aid of an endoscope.

Application of endoscopic technique in maxillofacial and neck

1. Endoscopic equipment

Endoscopic cameras, medical cold light sources, medical monitors, 0° or 30° endoscopes and supporting equipment.

2. Incision selection

The principle is to be concealed and easy to operate, and to be closer to the lesion. The commonly used incisions are as follows:

①Incision in the hairline or hairline: Generally, the incision is made at the hairline. If the incision in the hairline is required, it should be designed in a Z shape or a V shape, and the wound is more concealed. It is suitable for masses in the forehead, zygomatic and orbital areas;

②Postauricular and tragus margin incision: make an incision in the retroauricular crease behind the auricle or on the tragus margin, suitable for the mandibular angle area, preauricular parotid gland area, cheek, submandibular area and upper neck surface swelling excision of things;

③ Lateral neck striation incision: For neck masses and localized fat accumulation in the neck, a single small incision on the lower neck and lateral neck parallel to the skin striae is used.

3. Preparation of the working chamber under the microscope

The face and neck lack a natural chamber, and the operation chamber is not established by the inflation method, but the mechanical lifting and suspension method is used to enter from the natural fascia level. For example, the superficial surface of the platysma in the neck, the subgaleal aponeurosis of the scalp, the superficial surface of the parotid masseter fascia in the parotid gland area, etc., can be sharply separated with an electric knife or scissors. operate. After the tunnel and operating space are prepared, a long-head retractor is used to mechanically lift and suspend to establish a working chamber under the microscope.

4. Minimally invasive surgery to remove the tumor

When making tunnels and separating tumors, use low-power electrocautery for sharp separation, strictly control bleeding, and ensure a clear surgical field. If bleeding obstructs the operation, flush with normal saline. The bleeding point is easy to find under the magnification of the endoscope. Electrocoagulation precisely stops bleeding. The separation operation under endoscopic magnification is more precise than the operation under direct vision, the separation range is small, the trauma is small, and the tumor is easier to be completely removed. Even if the tumor is damaged, the residual part can be completely removed with the aid of an endoscope. The surgical area was sutured intradermally after irrigation.

Application value of endoscopic technique in maxillofacial and neck

The endoscope has two major functions: one is magnification. It can magnify the anatomical relationship of local tissues on the medical monitor, and can clearly identify some tiny anatomical structures, solve the contradiction between small incision and insufficient exposure, so the operation accuracy is improved, postoperative swelling and pain response are small, and the patient recovers quickly. The wound heals quickly and there is less chance of infection. The second is to extend the field of vision. The incision is selected in a distant hidden area, and with the help of an endoscope, the blind area of direct vision can be turned into a bright vision area. For vascular malformations and other masses with thin and easily ruptured capsules, and the risk areas with important blood vessels and nerves, they can be successfully carried out with the help of endoscopes.

The traditional surgical method for excising facial and neck tumors has short operation time, low cost, and low difficulty in operation. The endoscopic surgery has its unique advantages, namely, hidden incision, hidden scar, short-term effect is better, long-term effect is better. Despite the long operation time and high cost, more and more patients are willing to choose endoscopic surgery.