tailieunhanh - Marco Lucioni Practical Guide to Neck Dissection - part 3

Cổ được đặt ở một vị trí bình thường, hyperextended. Vết rạch là rất thấp và sau, cho phép phục hồi của tử thi cuối bóc tách mà không có vết sẹo làm biến dạng các khu vực phát hiện ra da. Tài liệu tham khảo của chúng tôi được mastoid và biên độ thấp kém của kiêu ngạo hàm dưới, clavicles, và manubrium sternal | Chapter 3 Superficial Dissection 3 Core Messages A large area of operation makes dissection easier. The cutaneous flap is raised between the platysma and the superficial cervical fascia as in vivo. The superficial cervical fascia is interrupted as little as possible. It contains the vessels and lymph nodes that in neck dissection would be removed with the specimen. Anatomic Layout The neck is placed in a normal position hyperextended. The incision is very low and posterior to allow reconstitution of the cadaver at the end of dissection without scars that disfigure the uncovered cutaneous areas. Our references are the mastoid and the inferior margin of the mandible superiorly the clavicles and the sternal manubrium inferiorly. Significant anatomical structures superficial cervical fascia platysma sternocleidomastoid muscle digastric muscle. Landmarks jugulum clavicle anterior margin of the trapezius mastoid mental protuberance laryngeal protuberance Adam s apple cricoid cartilage. Dissection A large cutaneous flap is raised with an incision approximately 3 cm beneath the inferior margin of the clavicle extending along the acromioclavicular joint and ascending laterally by approximately 3 cm behind the trapezius margin and posterosuperiorly to the posterior profile of the mastoid apophysis be yond the level of the external auditory canal Fig. . The flap may be raised above the platysma which thus becomes fully exposed Fig. . The platysma muscle extends from the corpus mandibulae to the outer surface of the Fig. Cutaneous line of incision 1 manubrium sterni 2 clavicle 3 acromioclavicular joint 4 anterior margin of trapezius muscle 5 mastoid 14 Superficial Dissection 3 Fig. Platysma muscle plane m mandible p parotid scm sternocleidomastoid muscle tr trapezius muscle c clavicle l larynx 1 platysma muscle 2 great auricular nerve 3 external jugular vein 4 superficial cervical fascia 5 spinal accessory nerve peripheral branch Fig. .