METHOD OF ELIMINATING DEFECT OF UPPER JAW Russian patent published in 2012 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to oral and maxillofacial surgery, and is intended for elimination of upper jaw defects. Dimensions of defect of alveolar process of maxilla are estimated and intra-operation stereolithigraphic patterns are made. In sampling autotransplant on access line in lower third of hip on projection line of femoral artery cut of skin up to 10-12 cm long is performed. Medial cutaneous nerve and great saphenous vein are isolated with their preservation. Sartorius muscle is pulled backwards with exposure of adductor canal. Descending knee artery, vein and subcutaneous nerve are found. Internal edge of medial belly of quadriceps femoris is mobilised and through it bone is reached. Vascular bundle is isolated. Osteotomy lines are marked on anterior-medial surface of lower third of femoral bone diaphysis in accordance with intra-operation pattern with dimensions 2-12 cm long, 1.5-4 cm wide, 0.5-2 cm thick. Ligation of vascular bundle in proximal part is carried out. Flap is cut off. Receiving bed is prepared. Cut is performed on anterior surface and crest of alveolar process of upper jaw with skeletonosation of bone surface. Mucous-periosteal grafts are mobilised from vestibular and palatal surface of upper jaw with excision of scar mucosa. Cut is performed from the side of upper jaw mucosa and upper labial artery is exposed along the length. In area of nasolabial fold cut of skin is performed, angular vein is exposed. Subcutaneous-muscular tunnel is formed. Exposed upper labial artery is rotated through formed tunnel into area of upper pole of nasolabial fold. Autotransplant is adapted and fixed in the area of defect by means of microscrews. Vasculare pedicle is passed through earlier formed subcutaneous-muscular tunnel in the area of nasolabial fold. Anastomoses with recipient vessels are applied: upper labial artery and angular vein with artery and graft vein of "end-to-end" type. Above fixed autotransplant mucous-periosteal grafts are additionally mobilized and sewn with U-shaped interrupted sutures.

EFFECT: method makes it possible to increase esthetic and functional effect, reduce trauma due to sampling of donor autotransplant, which has independent feeding, which does not depend on blood supply of receiving bed, scar and necrotic changes of soft tissues.

4 dwg, 1 ex