SU938964A1

SU938964A1 - Method of deepening entrance to the mouth after bilateral hiatus

Info

Publication number: SU938964A1
Application number: SU803004250A
Authority: SU
Inventors: Игорь Андреевич Козин
Original assignee: Московский Научно-Исследовательский Институт Косметологии
Priority date: 1980-11-12
Filing date: 1980-11-12
Publication date: 1982-06-30

Description

Изобретение относится к медицине, а именно к хирургической стоматологии.The invention relates to medicine, namely to surgical dentistry.

Известен способ углубления преддверия рта после двусторонней расщелины путем отсечения пролябиума от межчелюстной кости и перемещения к середине трапециевидных лоскутов из слизистой оболочки, выкроенных с помощью разрезов «кочерги» на переходной складке с обеих сторон и закрытия раненой поверхности премаксиллы [1].There is a method of deepening the vestibule of the mouth after a bilateral cleft by cutting off the prolabium from the intermaxillary bone and moving to the middle of the trapezoidal flaps from the mucous membrane, cut with poker cuts on the transitional fold on both sides and closing the wounded surface of premaxilla [1].

Однако известный способ не позволяет восстановить непрерывность круговой мышцы рта, так как культи ее не сшиваются друг с другом посередине, а дефект на задней стенке верхней губы закрывают лишь лоскутами из слизистой оболочки.However, the known method does not allow to restore the continuity of the circular muscles of the mouth, since its stumps do not stitch together in the middle, and the defect on the posterior wall of the upper lip is closed only with flaps from the mucous membrane.

Цель изобретения — восстановление непрерывности круговой мышцы рта.The purpose of the invention is the restoration of continuity of the circular muscle of the mouth.

Указанная цель достигается тем, что при осуществлении способа углубления преддверия рта после двусторонней расщелины путем отсечения пролябиума от межчелюстнрй кости и перемещения к середине трапециевидных лоскутов из слизистой оболочки, выкроенных с помощью разрезов «кочерги» на переходной складке с обеих сторон и закрытия раневой . поверхности премак2 силлы, выкраивают три лоскута из слизистой оболочки с основанием по периметру резцовой кости, далее последнюю закрывают этимй лоскутами по типу «конверта», при этом формируют заднюю стенку верх⁵ ней губы отслоением от верхней челюсти и сшитых друг с другом трапециевидных слизисто-мышечных лоскутов.This goal is achieved by the fact that when implementing the method of deepening the vestibule of the mouth after bilateral cleft by cutting off the prolabium from the intermaxillary bone and moving to the middle of the trapezoidal flaps from the mucous membrane, cut using the incisions of the "poker" on the transitional fold on both sides and closing the wound. the surface of premak2 sills, they cut out three flaps from the mucous membrane with a base along the perimeter of the incisal bone, then close the last one with these flaps according to the “envelope” type, while the back wall of the upper ^5th lip is formed by peeling from the upper jaw and trapezoidal muscular-muscular stitched together flaps.

• Способ осуществляют следующим образом.• The method is as follows.

Отсекают пролябиум вместе с подкожной клетчаткой от премаксиллы до основания носа. При этом одновременно выкраивают три малых лоскута из слизистой оболочки на задней стенке верхней губы по 15 периметру межчелюстной кости. Этими лоскутами закрывают раневую поверхность межчелюстной кости в виде «конверта». Далее с помощью разрезов «кочерги» на переходной складке выкраивают два трапе· циевидных слизисто-мышечных лоскута, МОбилизуют их от верхней челюсти, переме· щают к середине и сшивают между собой позади пролябиума. Таким образом одновременно формируют глубокое преддверие рта, закрывают раневую поверхность меж= челюстной кости и восстанавливают непрерывность круговой мышцы рта.Cut prolabium along with subcutaneous tissue from premaxilla to the base of the nose. At the same time, three small flaps are simultaneously cut from the mucous membrane on the posterior wall of the upper lip along the 15 perimeter of the intermaxillary bone. These flaps cover the wound surface of the intermaxillary bone in the form of an “envelope”. Then, using the “poker” cuts on the transitional fold, two trapezoid-like muscular-muscular flaps are cut out, they are mobilized from the upper jaw, moved to the middle and stitched together behind the prolabium. In this way, a deep vestibule of the mouth is simultaneously formed, the wound surface of the intermaxillary bone is closed, and the continuity of the circular muscle of the mouth is restored.

Пример. Больной Е., 20 лет, диагноз: деформация верхней губы и носа после двусторонней полной расщелины верхней губы. Проведена операция по предложенному способу. Восстановлена непрерывность круговой мышцы рта. За счет избытка отслоенной слизистой оболочки устранена выемка по нижнему краю центрального фрагмента губы, швы из конского волоса на края раны , на красной кайме. По ходу операции отслоены и перемещены медиально основания крыльев носа. Больной осмотрен через год после операции. Форма верхней губы и носа хорошие, рубцы мало заметные, преддверие рта свободное, глубокое, подвижность верх- 1 ней губы в полном объеме, выемка по нижнему краю центрального фрагмента губы отсутствует, мышечные валики при сжимании верхней губы «трубочкой» отсутствуют пролябиум подвижен. Отдаленный косме- ₂тический и функциональный результат хороший.Example. Patient E., 20 years old, diagnosis: deformation of the upper lip and nose after bilateral full cleft of the upper lip. The operation of the proposed method. The continuity of the circular muscle of the mouth has been restored. Due to the excess of exfoliated mucous membrane, the notch along the lower edge of the central lip fragment, the seams from horsehair to the edges of the wound, on the red border were eliminated. In the course of the operation, the bases of the wings of the nose are detached and medially displaced. The patient was examined one year after the operation. The shape of the upper lip and nose is good, scarring is not noticeable, the vestibule is free, deep, the mobility of the upper 1 lip is in full, there is no recess on the lower edge of the central fragment of the lip, there are no muscular ridges when compressing the upper lip with a “tube”. Remote kosme- ₂ matic and functional good result.

Предложенный способ применен на 22 больных. При этом установлено, что предложенный способ обеспечивает восстановление непрерывности круговой мышцы рта, 2 улучшает подвижность верхней губы, уменьшает ретрузию средней трети лица, улучшает условия для ортодонтического лечения и протезирования верхней челюсти.The proposed method was applied to 22 patients. It was found that the proposed method provides restoration of the continuity of the circular muscle of the mouth, 2 improves the mobility of the upper lip, reduces retrusion of the middle third of the face, improves the conditions for orthodontic treatment and prosthetics of the upper jaw.

Claims

(54) METHOD OF DEEPENING THE ORIGIN OF THE MOUTH AFTER THE BILATERAL CLEANING The invention is related to medicine, namely to surgical dentistry. There is a known method of deepening the mouth of the mouth after a bilateral cleft by cutting off the prol of the bium from the maxillary bone and moving to the middle of the trapezoidal flaps from the mucous membrane, cut using incisions "poker on the transition fold on both sides and closing the wounded surface of the premaxillary I. However, the known method does not allow restore the continuity of the circular muscles of the mouth, since its stumps are not sewn together with each other in the middle, and the defect on the back wall of the upper lip is covered with a patch of mucous membrane points The purpose of the invention is to restore the continuity of the circular muscle of the mouth. This goal is achieved by the fact that when implementing the method of deepening the mouth of the mouth after a bilateral cleft by cutting off the prol of the bium from the intermaxillary bone and moving to the middle of the trapezoidal flaps from the mucous membrane, cut with the help of cuts in the poker on the transitional fold on both sides and closing the wound. the surfaces of the premaxilla cut out three flaps from the mucous membrane with a base around the perimeter of the incisal bone, then the last is closed with these flaps in an “envelope” style, thus forming the posterior wall of the upper lip by peeling from the upper jaw and trapeziform mucous-muscular flaps with each other. The method is carried out as follows: Proline Bium is dissected together with subcutaneous tissue from premaxilla to the base of the nose. At the same time, three small flaps are cut out from the mucous membrane on the posterior wall of the upper lip along the perimeter of the maxillary bone. These flaps close the wound surface of the maxillary bone in the form of an “envelope. Next, using the cuts “pokers on the transitional fold, they cut out two trapezoidal mucous-muscular flaps, mobilize them from the upper jaw, peremb; Slipping to the middle and ssushivayu among themselves behind Prul Bium. Thus, at the same time, a deep vestibule of the mouth is formed, the wound surface of the jaw bone is closed and the continuity of the circular muscle of the mouth is restored. Example. Patient E., 20 years old, diagnosis: deformity of the upper lip and nose after a bilateral complete cleft of the upper lip. The operation according to the proposed method. Restored circular muscle of the mouth. Due to an excess of exfoliated mucous membrane, the notch along the lower edge of the central lip fragment, the seams of horsehair to the wound edges on the red border was eliminated. In the course of the operation, the bases of the wings of the nose are peeled off and moved medially. The patient was examined one year after the operation. The shape of the upper lip and nose is good, the scars are not very noticeable, the mouth mouth is free, deep, the upper lip is fully motile, the notch along the lower edge of the central lip fragment is missing, the muscle rollers are compressed when the upper lip is compressed. The long-term cosmetic and functional result is good. The proposed method is applied on 22 patients. It was found that the proposed method restores the continuity of the circular muscle of the mouth, improves the mobility of the upper lip, reduces the retrusion of the middle third of the face, improves the conditions for orthodontic treatment and upper jaw prosthetics. DETAILED DESCRIPTION A method of deepening the mouth of a mouth after a bilateral cleft by cutting off the prol of the bium from the maxillary bone and moving to the middle of the trapezoidal flaps from the mucous membrane, cut with the help of cuts on the transition fold on both sides and closing the wound surface of the premaxillary tissue, the purpose of restoring the continuity of the circular muscles of the mouth, cut out three flaps of the mucous membrane with a base around the perimeter of the incisal bone, then the latter is closed with these flaps n About the type of “envelope, while forming the back wall of the upper lip by peeling off the upper jaw and Trapeziform mucous-muscular flaps stitched together. Sources of information taken into account in the examination 1. Khitrov FM, Fomicheva E. U. Clinic and complex treatment of deformities of the alveolar process of the maxilla after damaged clefts of the upper lip and palate and subsequent operations. In the book. “Issues of dentistry and reconstructive facial surgery. M., 1971, p. 69-77.