SU1553071A1 - Method of treating deep defects of face and lower jaw - Google Patents

Abstract

This invention relates to the field of medicine, namely to surgical dentistry. The aim of the invention is to prevent atrophy of the graft and reduce the morbidity of the operation. The goal is achieved by cutting out a skin-muscular bone graft on the basis of the sternocleidomastoid muscle, including the distal end with the dermis located above it and the split periosteum. Further, it is isolated in the proximal part, leaving the neurovascular bundle, then cut off from the mastoid and layered fixation is carried out. A positive effect is evaluated by a decrease in relapse.

Description

The invention relates to medicine, namely to oral and maxillofacial surgery, and can be used in the surgical treatment of injuries and diseases of the mandible, accompanied by the formation of a defect in the soft tissues of the face and mandibular bone.

The aim of the invention is to prevent atrophy of the graft and reduce the morbidity of the operation.

The method is carried out as follows.

In a patient with a defect of the lower jaw and soft tissues, a scalpel cuts through the soft tissues in the area of the defect. Excised scar modified tissue and expose the bone ends of the mandible fragments. The latter are refreshed with the help of Luer pliers or a saw. When an atom is removed, the sclerotic areas are removed to the limit of the spongy layer. The periosteum is dissected with a scalpel and peeled off. Boron and a circular saw form on the ends of the refreshed fragments of the lower jaw of the site. On the neck (skin, subcutaneous tissue and fascia begin from the mastoid process and lead along the inner edge of the sternocleidomastoid muscle to the sternoclavicular joint. Then, by means of two elliptical incisions of the skin, the subcutaneous tissue and fascia form the skin portion of the graft above the distal equine chest - the clavicular-mastoid muscle and the sternal portion of the clavicle, the size of which depends on the size of the defect of soft tissues on the face.The collarbone is exposed in the area of the sternoclavicular joint and under the distal end The sternocleidomastoid muscle with a circular saw, boron and a wide chisel splits the sternal portion of the clavicle. A bone portion of the graft is formed that corresponds in volume to the bone defect of the lower jaw. From the flipped probe, the fascia above the sternocleidomastoid muscle is opened. the muscles form an L-shaped graft by making two longitudinal incisions from the mastoid process to the clavicle. One of them corresponds to the medial edge of the muscle, the other depends on the width of the bone portion of the graft, On the distal end of the muscle. Then proceed to the detachment of the skin-musculo-bone flap on the basis of

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i rudino-clavicular-eostoid muscles from the underlying tissues. When they reach the upper edge of the muscle, the flap preparation is stopped because the main vascular bundle is inserted into it from the medial edge to ensure greater mobility and eliminate tension on the basis of the sternoclavicular mastoid the muscles are cut off in the proximal part from the place of attachment to the mastoid process. The cut-free skin-musculo-bone tissue on the basis of the ore clavicular mastoid muscle is deployed in the area of Heels, hem the proximal end to the remaining muscle part and lead to the defect on the face through the subcutaneous tunnel. The bone part of the graft is placed on the refreshed surface of the mandible fragments and fixed with the bone bone. The edge of the muscle defect on the face is stitched to the edges of the muscle part of the graft) from the clavicular mastoid muscle Stitches on the skin edges of the defect and graft

The application of the proposed method completely complicates the recurrence of the disease, complication of osteomyelitis of the jaw, scarring of the soft tissues of the face. Ipaiicn idiiTdT based on ip is unique and carried the ipaiicn idiiTdT The cot value of the muscle with the preserved feeding leg creates favorable conditions for the vascularization and engraftment of all the components of the graft, which is especially important under the conditions of the knowingly infected bed of the lower jaw and the newly modified soft tissues of the face of the skin.

musculoskeletal flap on the basis of sternoclavicular-sosyaped muscle possesses great mobility and mobility. Compression and bending of its supplying leg and, consequently, atrophy and recurrence of the disease are completely eliminated. When the defect is restored on the face, the anatomical layer-by-layer structure of the area is fully restored. The proposed method allows one to avoid such traumatic intervention as a fence. ostnoy graft portion of the ribs, and consequently, the possibility of the PA Neny chest wall and pleural Furthermore, the graft of the clavicle is much stronger than the rib

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Claims (1)

Invention Formula A method for treating deep defects of the face and lower jaw, including cutting a skin-musculo-bone graft bath and moving it to a skin-musculoskeletal defect on the face, characterized in that. in order to prevent atrophy of the graft and reduce the morbidity of the operation, skin and musculoskeletal ipdHCiuidHTdT is cut out on the basis of i rchdino clavicular mastoid. including the distal end with the integument located by it and the cleft area with the periosteum, then are cut in the proximal part, leaving the bottom of the go-nerve of the bundle, then cut off from the mastoid process and carried out layer-by-layer fixation