Vijay P. Khatri MD FACS's Atlas of Advanced Operative Surgery PDF

By Vijay P. Khatri MD FACS

ISBN-10: 1416041095

ISBN-13: 9781416041092

ISBN-10: 145575398X

ISBN-13: 9781455753987

Enhance your surgical services with Atlas of complicated Operative surgical procedure! This new source alternatives up the place different surgical references depart off, supplying hugely visible, step by step suggestions on greater than a hundred complicated and complicated approaches in either common and subspecialty components.

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Extra resources for Atlas of Advanced Operative Surgery

Sample text

Imaging is helpful for the patient presenting with an aggressive parotid tumor, such as facial nerve palsy or a long-standing deep-lobe parotid tumor. Tumors in the tail of the parotid are usually Warthin tumors, and a preoperative fine-needle aspiration biopsy (FNA) is quite helpful. Even though there continues to be considerable controversy about the role of FNA, in select circumstances it is quite helpful. FNA will distinguish between salivary and nonsalivary pathology. FNA is also quite helpful in identifying suspected lymphoma or cystic lesions of the parotid, such as a benign parotid cyst or lymphoepithelial lesions of the parotid.

U The dissection continues superiorly in the pretragal area (see Fig. 3-2). The external auditory canal is exposed, and the dissection is done very close to cartilage to avoid any bleeding from the substance of the parotid gland. Any dissection in the parotid gland leads to a considerable amount of bleeding; therefore bipolar electrocautery will be helpful in this situation. u The dissection continues on the anterior surface of the external auditory canal until the fingertip feels the junction of the external auditory canal and bony canal.

A Harmonic scalpel may be used in this area to cut through the parotid tissue. However, it is important to recognize that the anterior blade of the Harmonic scalpel may cause surrounding tissue injury. u As the dissection is done anteriorly, the surface of the masseter muscle is exposed. The parotid duct may be noted in this region and should be clamped and ligated. Approximately 20% of the parotid tissue deep to the facial nerve is generally left in situ unless the tumor involves the deep lobe of the parotid gland.

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Atlas of Advanced Operative Surgery by Vijay P. Khatri MD FACS


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