INSTRUMENTS FOR RETRACTING SOFT TISSUE
It is critical to have good vision and good access to perform good surgery. To this end a variety of retractors have been designed to retract the cheeks, tongue, and mucoperiosteal flaps.
The two most popular cheek retractors are (1) the right-angle Austin retractor (Fig. 6-7) and (2) the offset broad Minnesota retractor (Fig. 6-8). Both of these retractors can retract the cheek and a ucoperiosteal flap simultaneously. Before the flap is create.d, the retractor is held loosely in the cheek, and once the flap is reflected the retractor is placed on the bone and is then used to retract the flap.
In addition to the Austin and Minnesota retractors other retractors are designed more specifically to reflect soft tissue flaps. The Seldin retractor is typical of this kind (Fig. 6-9). Although this retractor may look similar to a periosteal elevator, the leading edge is not sharp but rather is dull and should not be used to reflect mucoperiosteum.The periosteal elevator is often used as the primary instrument to retract soft issue. Once the flap has been reflected the periosteal elevator is positioned 0n bone and held there to reflect the tissue.
The instrument most commonly used to retract the tongue is the mouth mirror. This Is usually part of every basic setup, because it has both the usual use and use as a tongue retractor. The Weider tongue retractor is a broad heart-shaped retractor that is serrated on one side so that it can more firmly engage the tongue and retract it medially and anteriorly (Fig. 6-10). When this retractor is used care must be taken not to position it so far posteriorly that it causes gagging (Fig 6-11).
The towel clip can be used to hold the tongue. When a biopsy procedure is to be performed on the posterior aspect of the tongue, the most positive way to control the tongue is by holding the anterior tongue with a towel , dip local anesthesia must be profound where the clip is placed.