第八章头部手术主要内容一、牛断角术二、犬耳成形术三、.pptVIP

第 八章 头 部 手 术 主 要 内 容 一、牛断角术 二、犬耳成形术 三、犬耳矫形术 四、犬外耳道外侧壁切除术 五、马副鼻窦圆锯术 六、犬颌下腺及舌下腺摘除术 七、牙齿手术 八、牛脑多头蚴摘除术 无血断角（高位断角术） 位置在最上角轮和角尖之间，因没有破坏角突，不需止血和装角绷带。 【术后护理】术后注意绷带松脱，1~2月后断端角窦腔被新生角质组织充满。若感染引起额窦炎和化脓时，按化脓性窦炎处理。 去除耳尖部的巾钳或止血钳，分别 在两耳从标记点（缺口）到耳屏间 肌切迹（耳后缘的下端，耳屏与对 耳屏软骨下方耳与头的连接处）之 间的位置上装置断耳夹，断耳夹的 凸面朝向耳前缘。断耳夹装好后， 两耳应保持一致形态。 在外耳道中填塞脱脂棉球，以 防止血液流入外耳道中。沿断 耳夹凹面全部切除耳外侧部 分，除去断耳夹，彻底止血后 皮肤连续缝合。如果无断耳夹 可利用，可选择大小适当的肠 钳代替断耳夹。 【术后护理】 术后将耳廓拉向头顶，绷带包扎，或将两耳尖拉向头顶伸展，合并对齐后作一结节缝合，再用绷带包扎.5~7日解除绷带。如耳廓仍不能直立，可继续包扎。为防止犬用脚爪抓耳部，可装置颈环。 【术式】耳廓向头顶部偏斜的手术矫形 在耳基部与颅骨连接处的皮肤上作一纵向切口，切口距耳后缘约0.6cm，耳前缘约1.2~1.6cm；切开皮下组织，暴露盾形软骨，将它与相连的肌肉分离后向头顶中央稍偏向耳前缘的方向牵引，用水平褥式缝合把盾形软骨固定到颞肌筋膜上 缝合的位置依缝合后耳廓位置恢复正常或稍偏向头外侧而决定；皮肤和皮下组织结节缝合。将一个圆锥形的纱布棉拭放在耳腹侧，把耳廓卷到棉拭上并从基部包扎。 把圆锥形的纱布棉拭放在耳背侧并将耳廓卷到棉拭上包扎。切除椭圆形皮肤块的大小很关键，如果切除得太小，则耳廓仍向头外侧弯曲，而切除得太多，则可能造成耳廓向头顶偏斜。 Note that the incision is made directly over the break in the ear (inset,arrow). The amount of skin to be removed is determined by the severity of the deviation; it is better to remove too little than too much. Proper placement of three vertical mattress sutures. Note that the deep bite is carried through the subcutaneous tissues (inset). This is perhaps the most important step in the closure and ensures, in most instances, the correction ora lateral deviation. Proper tension on the sutures can be judged by the position of the ear when the sutures are tightened. Note that the ear stands with approximately a 10-degree lateral deviation. This is important because scar tissue will usually pull the ear medially. Lower inset, The ear is bandaged by placing a gauze sponge rolled in the shape of a cone in the external ear canal. The ear is folded around the sponge front both a cranial and caudal direction. Tape is applied in a dovetail fashion. The bandage is applied for three days. In most instances further bandaging is unnecessary. 如果耳廓在其基部发生弯曲 先用与术式 1 相同的切口和操作方法，把盾形软骨固定到颞肌筋膜上