[Expert Solution]: Case 3: Operative Report PREOPERATIVE…

Case 3: Operative Report PREOPERATIVE DIAGNOSIS: Intraoral lymphatic malformation, left buccal POSTOPERATIVE DIAGNOSIS: Intraoral lymphatic malformation, left buccal OPERATION: 1. Excision of intraoral lesion, left buccal 2. Graft with OASIS acellular matrix SPECIMENS: Left buccal lesion ESTIMATED BLOOD LOSS: Less than 5 cc FINDINGS: Left buccal lesion on the mucosal surface at the occlusal plane PROCEDURE: Patient was taken to the operating room, where she was placed under orotracheal intubation. Te left buccal mucosa was injected with 0.5 percent Marcaine with 1:200,000 Epinephrine. Te papilla of Stensen’s duct was identifed. Using a Colorado tip Bovie, the lesion was excised through the mucosa down to the level of the buccinator muscle. Te dimension of the lesion was approximately 3.5 cm in anterior-posterior dimension, 2 cm in caudal-rostal dimension. Using the cautery, we achieved hemostasis. Te specimen was sent for identifcation. Next, after shaping a template of the lesion with a sterile piece of paper, we shaped a graft of the shape of the defect with OASIS acellular sterile matrix. Tis was then sutured into place circumferentially using interrupted 4-0 Vicryl stitches as well as several closing sutures to the center portion of the graft. Next, using Vaseline gauze wrapped in a fne mesh, we formed a bolster that we placed over the OASIS graft and secured it into place with three 5-0 bolster stitches crisscrossed. Te patient was then awakened and extubated in the operating room successfully and taken to the PACU in stable condition. Tere were no complications.