SU1643005A1 - Method of treatment nose defects - Google Patents

Description

one

(21) 4413759/14 (22) 04/19/88 (46) 04/23/91. Bul Number 15

(71) Novosibirsk Medical Institute

(72) P.G.Sysol tin, A.M. Kozhevnikov, V.E. Günger and V.I.Itin (53) 616.475 (088.8)

(56) Mukhin M.V., Mamontov A.G. Clinical

operative maxillofacial surgeons.

Ed. N.M.Aleksandrova, L .: Medicine,

1985, 295-297.

(54) METHOD FOR TREATING DEFECTS

NOSA

(57) The invention relates to medicine, namely to maxillofacial surgery. The aim of the invention is to prevent the deformation of the formed floor. This goal is ensured by the fact that two plates of nonabsorbable porous material are transplanted into the subcutaneous tissue of the flap, the flap is placed in place, and after two weeks they are transferred as a single unit together with soft tissues. A positive effect is evaluated by an improvement in functional results.

The invention relates to medicine, namely to oral and maxillofacial surgery, and can be used for plasty of total nasal defects of various etiologies.

The purpose of the invention is to prevent deformation of the formed nose.

The method is carried out as follows.

The first step is to cut out the fat-skin flap in the frontal area v. replanting plates of porous titanium nickelide. For this, a skin, hypodermic fiber, not income up to 1 cm at the level of the outer edge of the orbit, is cut vertically from the hairline. Then, the incision is made at a right angle across the forehead to the inner edge of the eyebrow and then vertically up to the border of hair growth. The formed skin-fat flap is peeled off, it is placed on the inner surface in the projection of the supposed nasal bones and wing cartilage of two plates of porous titanium nickelide The required size and shape is 1 mm thick. The plates are fixed to the flap by 2-3 catgut sutures. In order to prevent the flap and implant from adhering to the underlying tissues, artificial skin is placed on the inner surface of them.

The flap is placed in place and the wound is sutured with a continuous intradermal suture.

The second stage is performed in two weeks and the formation of the nose is carried out. Cuts on the old postoperative scars cut through the skin and subcutaneous tissue, and then freely lift the skin-fat flap. By this time, the transplanted implants are firmly fixed on the flap; they grow through connective tissue that covers them with a thin layer from the inner surface. Artificial skin is removed from the inner surface of the flap and implant. From the tissues adjacent to the defect, form the inner lining of the nose. Then a slit from the curl of the auricle on the opposite side towards the calvarium and further downwardly arched

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cut through soft tissue before joining the outer edge of the flap. The entire skin of the hairy area is peeled off from the aponeurosis. The flap is moved to the defect and bent in the back of the nose so that the titanium nickelide plates replace the bone-cartilage skeleton of the nose, and together with the skin portion of the flap form a wing of the nose, then form the tip and nasal septum. The wound on the skull is covered with artificial leather and ointment dressing.

The third stage is carried out after 4 weeks, which is reduced to the fact that they cross the feeding leg in the area of transference, the rest of the flap is returned to its original place and the majority of the donor site is closed. The remaining defect on the forehead is replaced by a free skin graft.

Example. Patient Sh., 29 years old, history B-12170, entered the department of surgical dentistry of the Novosibirsk Regional Clinical Hospital 30.10.87. about the total post-inflammatory defect of the nose, in 1980. received a fatal gunshot wound to the face, during the last years, the patient was restored soft tissues of the submental region, floor of the mouth, lower and upper lips, eliminated the defect of the anterior portion of the hard palate and restored the continuity of the mandible with a revascularized rib graft.

4.11 87g the first stage of the operation was performed - the replanting of two porous plates of titanium nickelide, November 18, 1987, the second stage was carried out - the formation of the nose and 21.12 87g. produced crossing the legs. During all stages of the operation, the postoperative period was without complications, a satisfactory cosmetic result was achieved.

When viewed through 2 months. After surgery, the nose has a satisfactory shape, and the implanted implants are traced on the radiograph.

The proposed method is simple, non-effacing, prevents the deformation of the formed nose.

Claims (1)

Invention Formula A method for treating nasal defects by plastics a defect with a flap cut in the frontal leg with movement and stitching and subsequent cutting off, characterized in that, in order to prevent the deformed nasal deformation, two flaps of non-absorbable porous are transplanted into the subcutaneous tissue of the flap the material, the flap is put in place and in two weeks they are transferred as a single unit together with soft tissues