EKZENTERATION OF THE EYE-SOCKET

From Big Medical Encyclopedia

EKZENTERATION GLAZNYTSA

(exenteratio orbitae; lat. exenterare to take interiors) — operation of removal of contents of an eye-socket.

Operation is shown to hl. obr. at malignant tumors of an eye-socket (see). A contraindication for it is germination of a tumor in an upper wall of an eye-socket with radiological the defined defect of a bone. The special preparation for surgery is not required. An operative measure is carried out under anesthetic (see).

Distinguish subperiostal, a shouting-bitosinualnuyu and nadnadkostnichny E. At subperiostal E. on edge of an eye-socket on eyelids put a P-shaped stitch. An electroknife make a circular section of skin and subjects of soft tissues to a bone. The periosteum is otseparovyvat from bone walls. Extra care is shown at separation of a periosteum from an upper wall of an eye-socket. For the ligature imposed on eyelids tighten contents of an eye-socket and cross scissors a neurovascular bunch at its top. The remains of soft tissues and an eye artery are cauterized a ball electrode. The cavity of an eye-socket is washed out hydrogen peroxide; the wound is filled up with powder of an antibiotic or streptocide and tamponed the gauze tampon which is plentifully moistened with a liquid paraffin then apply a compressing bandage.

The Orbitosinualny ekzenteration is applied at distribution of tumoral process on walls of an eye-socket. In this case, having bared bone walls, make a resection of affected areas. In a trellised labyrinth delete all partitions, a lateral wall (an orbital plate), in a nasal cavity — nasal sinks. The scraping of a mucous membrane of subordinate clauses is obligatory (okolonosovy, T.) bosoms of a nose. The lower wall of an eye-socket is deleted after electrothermic coagulation of the lower orbital crack.

Nadnadkostnichny E. it is shown at early stages of development of a tumor. Operation there begin with a circular section of a conjunctiva on a limb and allocations of an eyeglobe. An eye and contents of an eye-socket delete through defect in the tenonovy capsule (a vagina of an eyeglobe, T.) or through previously made section of soft tissues on edge of an eyebrow.

For convenience of the subsequent prosthetics it is possible to replace a temporal muscle in a cavity of an eye-socket. For this purpose after removal of contents of an eye-socket allocate its lateral wall, in a cut resect the site of 1 in size >(1 cm. The prepared free top end of a temporal muscle is preposted through this opening and hemmed to a periosteum of orbital edge.

The first bandaging is done for the 5th days. It is recommended to delete a tampon gradually, moistening it with hydrogen peroxide. The subsequent bandagings make every other day. Considering the sizes of an operational wound p injury of the first bandagings> them should be carried out with preliminary introduction of analgetics and sedative pharmaceuticals. After extraction of a tampon the wound cavity is washed out alternately hydrogen peroxide and the concentrated solution of potassium permanganate. At the same time there is power tool cleaning of a cavity and irrigation of a wound surface elemental oxygen. Similar «oxygen trays» promote emergence of granulations in earlier terms. Upon termination of irrigation the wound is filled up with powder of an antibiotic or streptocide. The friable tamponade of a cavity is done within 12 — 14 days. In the next days bandagings of 1 — 2 time a week are recommended, and do not tampon a cavity of an eye-socket, and apply only a dry bandage. Prosthetics (see the Prosthesis eye) perhaps after epithelization of all wound surface (3 — 4 months later after E.).

Bibliography: Brovkina A. F. New growths of an orbit, page 198, M., 1974; P and-ches A. I., B r about in to and N and A. F. and 3 N-angirova of G. G. Clinical oncology of an organ of sight, page 290, M., 1980; The Guide to eye surgery, under the editorship of M. JI. Krasnova, page 311, M., 1976; H e p-der son J. W. Orbital tumors, N. Y., 1980; M e n n i g H. Geschwulste der Augen-hohle und ihre operative Behandlung, Lpz., 1970. A F. Brovkina.

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