SU1416110A1 - Method of curing insufficient function of soft palate - Google Patents

Abstract

The invention relates to surgery. The purpose of the invention is to improve speech in patients with paresis and paralysis of the soft palate. The pre-vertebral fascia is dissected and a flap is cut out on the leg from a long muscle of the neck, which is peeled off from the cervical vertebrae and stitched to the wound surface of the musculoskeletal flap. The method ensures the active functioning of the pharyngeal flap and soft palate even with severe atrophy of the pharyngeal compressed tissue.

Description

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The invention relates to: namely, the reconstruction of reconstructive surgery, and can be: used in surgical stoma: for the treatment of patients with paresis; MI or paralysis, as well as extensive, soft palate defects. : The aim of the invention is: speaking speech in patients with paresis and paralysis of the soft palate. : The method is carried out as follows.

 On the back of the pharynx, two I parallel cuts to the pre-pre-fascia fascia are cut and a mucous-muscular (pharynous: ous) flap is cut out on the upper supply knife; ke. The pharyngeal flap is taken on a handle and pulled away upwards for the best: a review of the prevertebral fascia - in the place where the flap is taken. Then, a vertical incision is made along the midline of the pharynx and dissected the prevertebral fascia, the indicated incision is continued horizontally in both directions. the level of the top and base of the wound defect. The sheets of the prevertebral fascia mobilize in the lateral directions and expose the prevertebral muscles. Together with the follicles of the prevertebral fascia, they peel off and move aside the sympathetic nerves and the adjacent neurovascular bundles of the neck. After that, the flap on the upper leg is cut out and cut off from the longitudinal part of the long neck (r. Longus colli) on the right or left side, depending on the intensity and location of its first fibers. The long one. The necks are initially exfoliated at the medial edge in the lateral direction and then the incisal tip of the cut-out flap is incised. Then they begin to mobilize the muscle flap upward, towards its base, of the muscle fibers section over the underlying anterior longitudinal ligament (lig Ipngitudinales aut,) and from the cervical vertebrae. After complete isolation of the leg from the long neck of the neck, its base is usually localized at the level of 1 cervical vertebrae. The mobilized muscle flap is transferred to the wound surface of the pharyngeal flap from the posterior pharyngeal wall and fixed to it by interrupted sutures. Stitches are laid from the base of the flap to its top.

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In a tact manner, an increase of: :::; second mass of the pharyngeal gloss. Peeled off sheets of the prevertebral fascia are returned to their original place and sutured among themselves. The wound defect of the posterior pharyngeal wall formed at the place of borrowing of the pharyngeal flap is also sutured. Then, if the contours of the soft palate are preserved (during paresis), a cut is made along the posterior lower edge of the soft palate, the tissues are cut into two layers and a pocket is formed between the oral and pharyngeal surfaces of the mucous membrane of the soft palate. The distal end of the formed flap consisting of a mucous-mucous flap from the posterior pharyngeal wall, including the upper pharyngeal squeezer and the long neck of the neck, is inserted into the formed pocket after epithelialisia. The flap is fixed to the sky by 4-5 separate U-shaped sutures, which are tied in the oral surface of the soft palate mucous membrane. With the elimination of extensive marginal defects of the soft palate, the flap is fixed to the severed tissue at the edges of the defect.

After fixation of the formed flap to the soft palate on the anterior or posterior palatine arches, depending on their severity. The flap is cut from the mucous membrane of a triangular shape so that its base is located at the level of the palatopharyngeal arch. This flap is peeled off over the upper layer of the palatine arch, and the resulting wound defect of the mucous membrane is pulled together and sutured with catgut throughout.

In order to better mobilize the flap from the palatine arch, the tissues under its base are stratified and, if necessary, a vertical incision is made of the oral splitted soft palate, starting from the medial edge of its leg. Next, the flap from the palate arches is moved and placed by the wound surface on the exposed portion of the prevertebral muscle as part of the flap being inserted, and the kegut sutures are fixed, which results in covering the muscle in the nasopharyngeal passage Hj, therefore, epithelialization of the flap formed from the oral cavity.

The proposed method makes it possible to form more functionally palatal glo 31416110

accurate shutter, as it provides for the increase in muscle mass: and

contractility of softness

palate due to the additional use of the function of the soft palate by slizirovanie in the composition of the implantable musculoskeletal flap from the back

mucous-muscular flap from the back wall of the pharynx on the leg, fixation of the laxal membrane of the pharynx of the muscular flap of izkut and the subsequent zittelnization of the early anteoptebral invertebral vesicle. The presence of a pre-surface that distinguishes the vertebral muscles (long neck) 10 with the fact that, in order to improve

even in cases of pronounced atrophy of patients with paresis and paralysis of the upper pharynx squeezer, providing soft palate, dissect assuming active functioning of the pharyngeal fascia and additionally cut flap and soft palate and, barely flap on the leg from the long muscular, promotes Improve the neck of the neck and hem it to the wound outcome of the treatment.

Claims (1)

Claim A method for the treatment of insufficiency of soft palate function with a mucus-muscular flap from the posterior pharyngeal wall on the leg, fixation of the flap and subsequent epithelialization of the wound surface, characterized in that, in order to improve speech in patients with paresis and paralysis of soft palate, the prevertebral fascia and additionally cut the flap on the leg from the long muscle of the neck and hem it to the wound surface.