METHOD OF PLASTIC ENDOSCOPIC FILLING OF NASAL SEPTUM IN CHILDREN Russian patent published in 2018 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to otolaryngology, and can be applied for surgical management of nasal septum perforation. Vertical incision of the mucous membrane of nasal septum to the left of olfactory zone to the bottom of nasal cavity is performed. At the level corresponding to the middle of middle turbinate, peduncle of the future graft is formed, including the branches of the anterior ethmoid artery. Incision is carried out to the bottom of nasal cavity and continue in transverse direction to the main plate of lower turbinate. In this case, the lower turbinate is temporarily displaced medially and upwards. Then the incision is continued anterior to the edge of the piriform aperture. Then scalpel is rotated in medial direction, perpendicular to the nasal septum and bring the incision to the front-bottom edge of the perforation. Dissection of perforation edges from the perforation side is performed. Wide amotio of mucoperiostal grap from the skeleton of the septum and the bottom of nasal cavity. Tissues are displaced anteriorly and upwardly, closing the perforation of the nasal septum with excess. Through vertical transseptal incision before perforation is performed. Graft on guide threads is conducted through incision in the other half of nasal cavity and deployed posteriorly, reaching the rear edge of perforation on the opposite side. Under endoscopic control, graft is straightened and sewn into the perforation edges, first on ipsilateral and then on the contralateral side. For imposition of intranasal sutures using 6/0 Vicryl on a round needle. Wound surface in donor area is filled with a sponge "Tahocomb". On reconstructed septum are applied silicone tires, which are fixed transeptal sutures.

EFFECT: method allows to increase the reliability of plastic closure of perforation of nasal septum in children and to reduce postoperative relapses by closing perforation of the nasal septum on both sides with a recurrent transseptal graft on the anterior ethmoid artery.

1 cl, 7 dwg, 1 ex