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Midfacial degloving

Implementation

  • The nasal cavities are vasoconstricted with adrenaline/tetracain tampons. 
  • The tumor is inspected with endoscopy.
  • Xylocain/adrenaline is injected into the appropriate area.
  • An incision is made 1 cm anterior to the tumor in the craniocaudal direction on the septum. 
  • The incision is brought all the way down to the floor of the nose.
  • An incision is made along the entire gumline.
  • The periosteum is dissected off the bone and the infraorbital nerve is identified bilaterally up to the aperture. 
  • The nasal floor is cut and the septum is separated toward the premaxilla.
  • The mid face is lifted providing good access to the nasal cavities.
  • The nasal septum is divided with scissors caudal to the tumor.
  • The septum is divided cranially with macroscopically free margins.
  • The specimen is removed and marked for histological purposes. 
  • The mucosa is inspected.
  • A frozen section is made of the mucosa and remaining cranial content of the septum.
  • Two tampons are inserted and saturated with Terra-Cortril® on the appropriate side. On the other side, a smaller Terra-Cortril® tampon is inserted. 
  • The nasal septum is sutured toward the nasal spine.
  • The incision is closed.

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