Originally published as part of the McMinn anatomy atlas family, McMinn's Color Atlas of Head and Neck Anatomy remains the only large format photographic. Interior of skull showing foramina (Atlas of Human Anatomy, 4th edition, Plate 11) . Clinical Note Netter Color Atlas of Ultrasound Anatomy. Since the first edition in , this book has set the standard in illustration of head and neck anatomy for students and clinicians at all levels.
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A colour atlas of head and neck anatomy. BOOK REVIEWS established surgeon will find little new but the book is worth reading for its thoughtful approach. who helped to make the Color Atlas of Anatomy a success. The large chapter 2 “Head and Neck” clinics are offered an atlas easy to handle and cope with. Download the PDF to view the article, as well as its associated figures and tables. Like the first Color Atlas of Human Anatomy, by McMinn and 1/2 in) and contains 80 color photographs of the bones of the head, neck, and.
National Capital District. A total transfixation incision is marked out on each side at the junction between the stratified squamous and respiratory colum- nar epithelium Fig. An Atlas of Head and Neck Surgery. A light nasal packing is done placed between the elevated palatal mucoperiosteum with mucoperios. It is a book for the surgeons room in the operating theatre. On the contralat.
All Webpages Books Journals. Hardcover ISBN: Published Date: Page Count: Instructor Ancillary Support Materials. Free Shipping Free global shipping No minimum order. Increased clinical relevance — helps translate traditional anatomy into current clinical practice All new state-of-the-art clinical imaging — including: Over additional figures — expands the imaging of normal and developmental structures and highlights common and clinically important variations, anomalies, defects and diseases Interactive question bank - over multiple choice questions to aid exam preparation and check your understanding.
English Copyright: The medialward dissection is done carefully to avoid accidental entry into the larynx. A nylon suture is passed through the substance of the vocal cord around the anterior end of the vocal process.
The suture is fixed through a separate holes made at the posteroinferior aspect of the thyroid cartilage. At this stage the thyroid cartilage is returned to the neutral position and the assistant passes a fibreoptic nasolaryngoscope to see the intercordal distance which, after tightening the sutures, should be between 4 and 5 mm. Endoscopic examination also confirm the extramucosal nature of the procedure. With the help of a fine elevator, the inner perichondrium of the thyroid cartilage is elevated and the laryngeal soft tissues are sepa- Fig.
This step is continued till a paramedian on the necessity of neck dissection. The tracheostomy could be per- tunnel is created between the upper and lower border of the thyroid formed at the beginning or at the end of the procedure cartilage.
The triangular portion of the thyroid carti- lage is left attached to the underlying laryngeal soft tissues. The strap muscles are separated in the midline. The muscles are retracted laterally using a self-retaining retractor to expose more than the anterior half of the thyroid cartilage. The distance of this incision from the midline depends on the extent of the tumor which now could be visual- ized through the aperture created Fig.
The degree of posterior resection depended on the tumor extension towards Fig. With the help of a sharp scarple or sickle knife. To prevent the posterior retrac- tion. The rest of the incision is closed in two layers Fig. A functional neck dissection is per- formed at this stage Fig. This step oblique line of the thyroid cartilage labelled C in the picture are cut is necessary to achieve wider resection on the diseased side and the larynx is rotated by a hook.
A subplatysmal skin flap is elevated at least 1 cm the internal laryngeal nerves preserved above the level of the hyoid bone. The former muscles are dissected With the help of the perichondrial elevator. It is passed along the anterior lage. Using a perichondrium elevator.
The Fig. The muscles along the lying the cricoid cartilage is elevated on the side of the tumor. The superior laryngeal vessels are identified and ligated. A tracheal intubation is done while the oroendotracheal tube is removed The larynx is entered through a inferiorly directed horizontal pharyngotomy arrow head thereby preserving the entire epiglottis.
At this stage. The vertical prearytenoid incision and aryngeal resection is performed under direct vision.
The will assist the anterior motion of the remaining arytenoid Fig. The endol. The specimen is removed and hemostasis is achieved. This allows the eral side. The cuts are made over the arytenoid. On the contralat. The previously sectioned tongue and lastly. They are passed to released cervicomediastinal trachea moves upward.
The remaining removed entirely and there is no perforation of the pyriform sinus arytenoid cartilage is pulled forward to the posterolateral aspect of the mucosa. The tension is less in the suture line as the previously line and one on either side 1 cm away from midline. The neck is flexed and the sternohyoid muscles are sutured.
At this stage the encircle the cricoid cartilage. The mucosa of the arytenoid cartilage is sutured covering the cricoid cartilage to avoid the posterior sliding of the former cartilage.
The remaining arytenoid mucosa is sewn over the denuded Fig. This is done to preserve the pyriform sinus mucosa during removal of the specimen Fig.
After removal of the cles inferiorly hyoid bone. The thyroid cartilage incision lage to be resected and the underlying perichondrium. With a Stryker is continued superiorly at each side along the lines corresponding to the saw.
Depending on the extension of the tumor. After catgut exposure of the pharynx. The tip of the epiglottis is grasped and retracted anteriorly and inferi- orly. The neck is flexed and the laryngeal mucosa sutures are placed through the base of the tongue. Guardian sutures are placed between the skin of the chin and the manibrum with two silk to prevent sudden over extension of the neck as described in Fig. The branches of anterior jugular vein and the common carotid artery.
The dissection is continued to the level of the clavicle below fied and dissected in its medial plane. The superior belly of omohyoid muscle is incised Fig. The superior and inferior thy. The carotid sheath is identified and hyoid above on both sides. The larynx is now free of muscular attachments. Incision of sternal attachment of the strap muscles exposed the trachea. The thyroid gland on the contralateral side is peeled off from the trachea by blunt dissection and preserved Fig. The surgeon with headlight medially just below the level of the superior border of the cricoid carti- moves to the head end of the table.
Through the pharyngotomy. Both cuts are joined posteroinferior to the Fig. The shape of the tracheal cut is made so it new tracheostoma is made through the skin below the tip of the incision extended backward and obliquely upward making the membranous part in patients who did not have any prior tracheostomy. The anesthetist 5 mm higher than cartilaginous one gradually remove the orotracheal tube and the surgeon insert a new tube Fig. A through the tracheostoma. Usual pharyngeal closure line look like a wards or vice versa.
The third layer of the pharyngeal closure are made using pharyngeal rupted sutures so as to bury the first one. Particular up with a fine. Using a heavy and fine sutures the peritracheal fascia is stitched to the subcuta- neous tissues around the tracheostoma. Additional suturing of the skin to the mucosa above the tracheal cartilage is necessary to make the closure airtight. A suction drain is inserted and the skin flaps are sutured with the tracheostoma and with the rest of the cervical incision Fig.
By traction on the pharynx and esophagus the stomach is mobilized to the neck. Same time the stomached is mobilized endoscopically or by open abdominal surgery Fig. Then the anterior wall of pharynx to stomach is closed. After the posterior wall of the pharynx is sutured to the stomach a nasogastric tube is passed to the nose and directed to the stomach.
The wound is closed in layers Fig. An opening is created at the fundus of the stomach and anasto- mosed with the pharynx. The lumen is closed. Vocal cords and subglottis are normal. Patient is tracheostomised to relieve airway obstruction Fig. The hyoid bone is divided on both sides anterior to the digastric muscle attachments and lateral to the lesser cornu. A penrose drain is inserted and the incision is closed in layers Fig.
Tracheal opening arrow is made above the level of the stric- ture between first and second tracheal rings. The initial anastomotic suture is placed in the posterior midline so the knot is extraluminal. A hemostat holds the suture Fig. The vicryl sutures are started from the posterior surface of the trachea and preceded anteriorly. The anesthetic circuit is moved to the head from the neck to be connected to the endotracheal tube Fig.
The patient is kept intubated for 5 days. The stay sutures are tied together Fig. Guardian sutures from the sternum to the chin are placed to prevent overextension. Thyroid 3 3. The platysma muscle is cut and the dissection proceed cranially dissection is continued till hyoid bone is reached in the subplatysmal plane S. A drain is placed in the subplatysmal plane and the platysma muscle reapproximated.
The tongue base and its musculature are sutured together. The tract is followed through the hyoglossal muscle till the base of the tongue is reached Hyoid bone Fig. The skin is closed. The right ing between the lateral borders of sternocleidomastoid muscles for neck common carotid artery is exposed dissection as well.
The tumor with neck dissection specimen is removed in one piece. The incision is closed as in hemithyroidectomy. The incisions lieds 2. Salivary Glands 4 4. At the angle of the mandible. Elevation of the fascia over the submandibular gland further protects the nerve Fig.
The anterior part of the gland is held with a Allis forceps and the facial artery and vein entering the lower border of the gland are ligated. The lower part of the gland is elevated by following the hyoid posteriorly to free the part of the gland which curves backwards over the mylohyoid muscle. The specimen is examined in its entire form a and b cut section and sent for histopathological examination.
The tail of the parotid gland is dissected off the sternocleidomastoid muscle by dissection deep to the posterior branch of the greater auricular nerve. The flaps are retracted with silk sutures. The anterior flap is raised superficial to the greater auricular nerve and the parotid fascia. The greater auricular nerve as it runs over the sternocleidomastoid muscle is identified and preserved. Elevation of the posterior and inferior flap exposed the tail of the parotid.
This exposed the tragal pointer. The greater auricular nerve is identified and preserved. The facial nerve trunk is identified as described in Fig. Then the deep lobe is dissected Fig. A sunction drain is inserted. The facial nerve trunk is also resected with the tumor when it cannot be separated from it. The sural nerve to be used for anastomosis is marked out as it runs along the lateral malleolar fold Fig.
To have extra length for facial nerve anastomosis. The facial nerve is freed from the fallopian canal. Canal wall down mastoidectomy is done. The branches of the sural nerve are anastomosed to the upper and lower branches and the main nerve anastomosed to the facial nerve trunk Fig.
The internal jugular vein arrow and skeletonized lateral sinus arrow head in mastoid cavity are exposed. The elevation of the skin flap is carried out till the superior temporal line is reached and in both anterior and posterior direction till an adequate dimension of the flap to cover the raw area created by parotidectomy is reached. The branches of the superficial temporal artery are cut and ligated at the margin of the flap Fig.
A drain is inserted and the incision closed in layers. Repair of External Nose Defects 5 5. The skin above the defect is used as rota- tion flap for inner lining. The skin is dissected out at the subdermal level and a pedicle is developed Fig.
The donor area is closed Fig. The flap is tunnelled subcutaneously to the defect. This flap is based on supraorbital and supratrochlear arteries and had 2 pedicles which are label A and B in this picture.
The skin edges of the donor area of the flap are approximated. First stage. The flap is wider in deeper plane than superficial giving it a trapezoidal shape in cross sec- tion. After 2—3 weeks of the second stage. This delay is continued until the blanching response of the flap tissue to finger pressure disappear within 3 seconds.
Begins 4 weeks after the first stage. A thin ply is occluded partially.
The strangulation is gradually increased. Pedicle of the flap is returned to the forehead. Four weeks later the flap healed satisfactorily and its distal end is divided near the nasal tip.
The donor area covered with split thickness skin graft. After Fig. The area to be refreshened around the nose defect is also marked out Fig. The orifice of the parotid duct marks the posterior limit of the flap S.
Axial and Free Flaps 6 6. The anterior incision lies 1 cm posterior to the oral commissure. With the patient in supine position and the head extended. It is ligated and by following its proximal course. The flap is completely mobilized from the neck with the facial artery and vein in view. The inferior labial artery is identified and ligated Fig.
The flap with its vas- cular pedicle is passed under the nerve to the neck. The flap marked is out with interrupted diathermy point Fig.
This freed up the greater palatine vascular pedicle and flap becomes rotatable Fig. The upper limit of the flap is marked along is outlined by an index finger-thumb pinch test to assess primary the mandibular arch in the submental region from the ipsilateral angle closure. The inferior limit of the flap face and head are prepared.
When dissecting the upper margin of the preserved. The dissection is continued till the midline is reached flap. The dissection is proceeded towards the pedicle on the surface of the submandibular gland until the facial artery is reached. Dissection is carried down to the origin of the facial artery and vein till a pedicle of desired length is obtained Fig. In this case. The flap with its pedicle is passed below the bridge of skin Fig.
The nerve is care- fully dissected out and the flap is passed under it. The position of the man- dibular branch of the facial nerve. Inner mucosa is closed with a alternate flap Fig. The flap is marked out depending on the size of the defect to be reconstructed Fig.
Pectoral nerve arrow head exiting the pectoralis minor is identified and transsected Fig. The cephalic vein and radial artery are forearm through the use of an elastic bandage and raising the tornique transsected and ligated to mmHg. The distal skin incision is made to gain exposure of the. The skin flap is elevated with the deep fascia Fig. The tornique is released. Mandible 7. The soft tissue attach- Fig. In the oral cavity the incision is made along the medial border of the mandible in the midline to the retromolar trigon area.
Dubey, C. This separates the neurovascular structures deep to the rib Fig. The outer peri- osteum reflected Fig. The incision is closed. A longer plate is used so it is plated to the excised ends of the mandible Fig. The gingivolabial and gingivolingual mucosa are close water tight to prevent saliva leak into the graft site.
Fibula graft is reinforced with mini plate and screws and attached to the remaining mandible on each side. The vermilion border of the lips also marked Fig. Similarly an equal triangular area is marked out in the upper lip whose length is equal to the half of the defect. Buccal aspect of the tumor shows minimal extension S. Lips and Face 8 8.
It is used to reconstruct one-third of the excised lower lip. The cut ends of the lip is sutured Fig. The scar is eventually indistinguishable. The medially based flap is designed.
The lip commissure is formed in the process of flap rotation. A crescentic incisions extending bilaterally from the nasolabial crease around the oral commissure and into or near the lower lip defect are made. The orbicularis oris muscle and labial artery pedicles are preserved. The oral sphincter function is maintained but significant microstoma resulted Fig.
The donor area is also closed in layers. The forehead flap is elevated and is splitted in the middle. The split flap is rotated to cover the defect. This bulk of muscle is split into equal anterior and posterior parts or arms except for its cranial 2 cm. The anterior third of the temporalis is elevated.
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McMinn's color atlas of head and neck anatomy, 4th edn McMinn's color atlas of head and neck anatomy, 4th edn Authors: Bari M. Oxford Academic. Google Scholar. Split View Views. Cite Citation. Permissions Icon Permissions. All rights reserved.