From Big Medical Encyclopedia

DENKERA OPERATION ( A. Denker , it is mute. the otorhinolaryngologist, 1863 — 1941) — operation on a genyantrum. It is offered by A. Denker in 1905 for treatment hron, antritis for the purpose of removal of pus and patholologically the changed fabrics from a bosom.

Flow diagram of Denker: 1 — the line of a section of soft tissues; 2 — an exposure of a front wall of a genyantrum and edge of piriform opening; 3 — the anastomosis between a genyantrum and the closing nasal stroke created in the course of operation; 4 — defect of an upper jaw after Denker's operation.

Make a section of soft tissues (to a bone) below a transitional fold (1 cm higher than edge of a gum). The section is begun from the third painter of the relevant party and, cutting a bridle, continue on 1 — 2 cm on the opposite side. A. Denker recommended to reject a medial part of a section slightly up (fig., 1). Some specialists consider a section of a bridle optional. Soft tissues with a periosteum otseparovyvat up, and bare not only a front wall of the corresponding bosom, but also edge of piriform opening (fig., 2).

Beginning from edge of piriform opening otseparovyvat a mucous membrane of the closing nasal stroke from a bone of a lateral wall of a nasal cavity. Delete, using preferential bone nippers or a chisel, a front wall of a genyantrum and edge of piriform opening, and then a lateral bone wall of the closing nasal stroke up to a back wall of a bosom (fig., 3 and 4). After removal of pus and patholologically the changed fabrics cut a mucous membrane of the closing nasal stroke along upper and back edges of a bone opening. The formed mucous graft is stacked on a bottom of a bosom and fixed a tampon. In those cases when the mucous membrane of a bottom of a genyantrum is not deleted, the mucous membrane of the closing nasal stroke is excised. Regarding cases make a resection of the lower sink. On an operational wound in anticipation of a mouth put stitches. The tampon (if it was entered) is removed from a bosom in 1 — 2 days. In 4 — 5 days after operation remove seams. Through an opening in the closing nasal stroke by means of a special cannula in the postoperative period wash out a bosom antiseptic solutions.

In modern the wedge, the practician D. of the lake at antritis is almost not applied in view of its injury. It is made mainly for creation of quick access to average and back departments of a nasal cavity, to a nasal part of a throat (for the purpose of removal of new growths, foreign bodys, and sometimes for elimination of choanal atresias).

See also Paranasal sinuses .

Bibliography: The multivolume guide to otorhinolaryngology, under the editorship of A. G. Likhachev, t. 4, page 63, M., 1963; D e n k e And. Zur Radikaloperation des chronischen Kie-ferhohlenempyems, Arch. Laryng. Rhin. (Berl.), Bd 17, S. 221, 1905.

Yu. B. Preobrazhensky.