SU833215A1 - Method of lengthening soft palate - Google Patents

Description

(54) METHOD FOR EXTENDING SOFT SKY

one

The invention relates to medicine, namely to reconstructive surgery and dentistry, and can be used in the treatment of shortenings of the soft palate of various origins, in particular in the treatment of patients with congenital clefts of the palate, who after the initial unsuccessful uranoplasty have a shortening of the soft palate, a violation palatopharyngeal closure, resulting in the restoration of normal speech.

There is a known method of lengthening the soft palate by separating the mucoperiosteal flaps of the hard palate, displacing the palate in the back, cutting off its nasal compartment along the border of the hard palate, followed by epithelialization of the wound surface 1 formed.

However, with the implementation of this method, there is no objective criterion for evaluating the required displacement of the soft palate back, which adversely affects the results of the operation and leads to unsatisfactory functional outcomes.

The purpose of the invention is to determine the required amount of sky displacement and the formation of a flap in the shape of a defect.

The goal is achieved by the fact that, when implementing the method of extending gogoneby by separating mucous and nodular grafts of the hard palate, displacing the sky behind, cutting off the nasal section along the hard palate, followed by epithelization of the resulting wound surface, after cutting off the nasal part of the palate along the hard palate, apply the lesion of the palate to the border of the hard palate followed by epithelization of the resulting wound surface. between the posterior pharyngeal wall and the upper-posterior surface of the palatine curtain, the reamers and the shape of the flap are determined to close the resulting wound erhnosti and form a flap on the two legs of the vascular supply anterior muco-periosteal flap hard palate.

The method is carried out as follows.

After incisions along the cheeks of the teeth, the back of the alveolar process, detachment. a mucoperiosteal flap is dissected and the lateral wall of the ilotus is dissected, and the neurovascular bundle is excreted on both sides by cutting it off from the elastoperiosteal flap for 2/3 the length of the flap. Further, scars are layered on the skin.

the sky, at the place of its attachment to the hard palate and, 5–7 mm indented behind it, the nasal part of the palatine curtain is cut parallel to the posterior edge of the hard palate by a cut. In cases where during the primary uranoplasty no epithelization of the nasal surface of the mucoperiosteal flaps was performed, then the BQ time of exfoliation of the latter with repeated intervention results in a defect in the lining in this area. Interlaminar osteotomy is performed. To determine the required amount of mixing backwards, the soft palate is temporarily fixed by a U-shaped suture to the back of the throat. At the same time, a defect of the mucous membrane is formed on the nasal / sky surface and is subject to compensation. In the anterior section of the mucous-periosteal flap of the hard palate posterior to the place where the detached neurovascular bundles enter, the latter is cut off to form an ovoid-shaped rum on two feeding legs. This flap is tilted by 180 °, displaced posteriorly and spread into the nasal cavity by an epithelial surface into the nasal cavity and is fixed along the edges with knotted catgut sutures. The remainder of the mucoperiosteal flap in the anterior section is stitched with catgut sutures and placed on the wound: the surface of the transplanted flap and the distal portion of the hard palate. To ensure good contact of the wound surfaces, 1-2 catgut U-shaped sutures are applied in this area. The wound surface of the sky is covered with iodine-shaped tampons, a protective plate is put on. The U-shaped suture, which fixes the soft palate to the back of the pharynx, is removed after the transplanted graft is engrafted (7–9 days after surgery).

The application of the proposed method gives the exact amount of required displacement of the soft palate to the back, increases the engraftment of the transplanted flap, which provides the possibility of lengthening the soft palate and prevents its shortening in the postoperative period, providing good functional (speech) operation Lhoda.

Claims (1)

Invention Formula The method of lengthening the soft palate by separating the mucous-periosteal flaps of the hard palate, blending the palate posteriorly, cutting off the nasal compartment along the hard palate, followed by epithelialization of the resulting wound surface, in order to Determine the required amount of palate displacement and to form a flap after the cut-off of the nasal part of the palate, a provisional suture between the posterior pharyngeal wall and the upper-posterior surface of the palatine curtain is imposed on the border of the palate, the size and shape of the flap to close the wound surface that has formed, “form a flap on the two supplying vascular legs from the anterior section of the periosteal mucosa of the hard palate. Information sources, taken into account in the examination I. Vernadsky Yu. I. Traumatology and restorative surgeons of the maxillofacial region. K., "Health, 1973, 5 s. 136-137.