FIELD: medicine.
SUBSTANCE: musculocutaneous flap of the latissimus dorsi with thoracodorsal vessels and nerve is formed. From the vascular branch which extends from the thoracodorsal vessels to the anterior serratus, an additional muscle flap is formed from the fibres of the anterior serratus. The facial artery, vein and hypoglossal nerve are isolated and prepared for anastomosation. The vascular pedicle of the previously formed flap is transected. The flap is rotated into the defect area. End-to-end anastomosation between the facial arteries and the thoracodorsal artery, between the facial vein and the thoracodorsal vein, between the thoracodorsal nerve and the hypoglossal nerve is performed. The flap is transferred and rotated into the oral cavity, fixed with separate interrupted sutures to the root of the tongue. The diaphragm of the oral cavity bottom is formed from the anterior serratus.
EFFECT: allows to ensure the replacement of large defects, restore the function of swallowing and speech.
3 dwg
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Authors
Dates
2017-09-04—Published
2016-09-28—Filed