SU1219056A1 - Method of eliminating defects of infraorbital-zygomatic sections of patients with maxillofacial dysostoses - Google Patents

Description

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The invention relates to medicine, namely to the field of reconstructive reconstructive surgery, and can be used in surgical dentistry.

The aim of the invention is to prevent the disruption of the integrity of the circular eyelids of the eye due to the achievement of the complete restoration of the relief of the infraorbital-zygomatic tissue.

The method is carried out as follows.

Under endotracheal anesthesia, a skin incision is made along the projection of the base of the lower eyelid with a transition at the outer corner of the eye 1.5-2 cm into the temporal region along the line of wrinkles. The skin around the incision is peeled off in an acute and blunt way with a part of subcutaneous fatty tissue, the width determined by the shape of the implant being inserted, / The periosteum detachment starts from the lower edge of the orbit and continues to the front surface of the upper jaw. By preparing the bed in this way, a simulated silicone implant is inserted into it, which is in its shape. full em. the coitus defect, namely, the absent infraorbital rim, the bottom of the orbit, the apical zygoma and. the zygomatic arch, the Implant is fixed to the periosteum with chromed catgut or polyester. After filling with a shmplant; bone defect carried out n; the astika of the soft tissues of the infraorbital-zygomatic region, since the wound of the defective soft tissues remains open over the transplanted implant, For this purpose, a skin-fatty arterialized flap on the feeding stalk is used, cut out from the frontal region temporal artery and vein. Preliminarily, the course of the superficial temporal artery and its frontal branch is determined and marked with diamond greens. In the temporal region, starting from the upper pole of the auricle, a skin incision is made laterally from (projection of the temporal artery by 0.5 cm). upward, and the frontal area and cut out the skin and fat flap, respectively, the projection of the frontal branch of the temporal artery and the shape of the wound defect in soft tissues of the infraorbital-zygomatic region,. Skin. 9056

the fat flap is peeled off from the underlying fascia. The wound at the site of the flap is stitched, bringing the edges together. Separating the flap legs is carried out with great care not to injure the vascular bundle and not disrupt the blood supply. Dp this is removed and mobilize the main trunks of the superficial temporal artery and veins with

0 surrounding fatty tissue to the upper layer of the zygomatic arch. After that, a tunnel is formed under the skin in the temporal region, starting from the medial edge of the leg of the cut out flap from

5 of the frontal region towards the outer edge of the orbit and connected to the wound defect, the Formed skin and fat flap is rotated and guided through the subcutaneous tunnel,

0 into the wound defect, set over the implanted implant and sewn to the edges of the wound defect with polyamide thread. The angle of rotation of the stem, of the flap does not exceed 90, which ensures a good blood supply to the flap. Thus, plastic surgery of soft tissues is carried out in the infraorbital-zygomatic region; A similar surgical procedure is performed on the opposite side,

g Example, Ill B ,, 30 years old, was admitted to the clinic with complaints about the presence of a cosmetic defect, face deformity. From the anamnesis, it was established that the disease is congenital, previous surgical treatment was not performed. On the basis of clinical and functional methods of examination, a diagnosis was made: maxillofacial dysostosis,

The operation is performed according to the proposed method.

Under endotracheal anesthesia, a skin incision is made along the projection of the base of the lower eyelid to the right with a transition at the outer angle of the thlase 1.5 cm into the temporal region along the line of wrinkles. The skin around the incision is peeled off in a sharp and blunt way with part of the subcutaneous tissue. The periosteum is exfoliated from the lower edge of the orbit downward, in the direction of the front surface of the upper jaw. A previously individually modeled silicone implant is inserted into the prepared bed.

5 and fixed to the periosteum of chromium-plated catgut. Then proceed to closing the wound defect, which forms in the infraorbital-zygomatic region.

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The area above the implanted implant is 2.0 x 5.0 x 0.3 cm. To do this, from the frontal area on the right side, the skin and arterial flap of the feeding leg contains the main trunks of the superficial temporal arteries and veins. The skin incisions are made according to the direction of the superficial temporal artery and its frontal branch, 0.5 cm indent of their projection. The skin-fat flap is peeled off from the underlying fascia, the wound at the site of the flap is sutured, bringing the edges together. Then, together with the flap leg, the main trunks of the superficial temporal artery and veins with the surrounding fatty tissue to the upper zygomatic arch are mobilized and mobilized. After that, under the skin in the temporal region, starting from the medial edge of the leg of the cut flap, a tunnel is formed towards the outer edge of the orbit and is connected with.

Editor V. Ivanova

Compiled by M. Pozn to

Tehred I. Veres Proofreader V. But ha

Order 1178/6 Circulation 659 Subscription

VNRSHPI State Committee of the USSR

for inventions and discoveries 113035, Moscow ,. Zh-35, Raushsk nab ,, d.4 / 5

Branch ShSh Patent, Uzhgorod, st. Project, 4

I90564

wound defect. The formed skin and fatty flap is conducted through the subcutaneous tunnel and removed in the wound defect, set over the planted implant and press the polyamide thread to the edge of the wound defect;

The postoperative course is smooth primary healing. At discharge, a complete engraftment of the transplanted flap and restoration of the spruce of the infraorbital-zygomatic region were noted.

At the control examination, 8 months after the operation, good anatomical and functional results were noted. Deformities of the eyelid of the eyelid, the palpebral fissure and deformity in the infraorbital-zygoma area were eliminated. The relief of the infraorbital-zygomatic region of priolk-.

20 zhey to norm, eversion of the lower eyelid is fixed. The transplanted flap did not contract, it was practically the same color as the surrounding tissue. The scar, bordering the flap, little notice.

Claims (1)

METHOD FOR ELIMINATING DEFECTS OF THE ORBROBITAL-ZYBOMIC REGIONS IN PATIENTS WITH JAXO-FACIAL DYSOSOSES by implanting a silicone implant through a skin incision along the projection of the base of the lower eyelid and soft tissue plastic with a flap on the feeding leg, which is designed to prevent the muscles from breaking in order to prevent damage to the entire muscle, so that , as a flap on the feeding leg, a skin-fat arterialized flap from the frontal region is used, which is carried out through the subcutaneous tunnel formed in the tissues of the temporal region in the direction NIJ to the outer edge of the orbit, and sutured to the edges of the wound defect. Q © SU „,, 1219056