METHOD FOR SIMULTANEOUS ELIMINATION OF BODY DEFECTS AND MANDIBULAR BRANCH Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery, and can be used for elimination of body defects and mandibular branch arising as a result of block resections of tumors, heavy mechanical injuries and gunshot wounds. Perform single-stage elimination of body defects and mandibular branch by preparing sensory bed by soft tissues dissection in projection of lower jaw defects, resection of the body and mandibular branch, extraction of the facial arteries and vein in the submandibular region and the external jugular vein, sampling of the fibular autograft on the vascular pedicle, its modeling according to the prepared patterns with the subperiosteal wedge-like osteotomy, fixation of obtained fragments with each other at angle of 110–120°, replacement of body defects and a mandibular branch with a formed fibular autograft, superposition of anastomoses between a facial artery and an artery of a fibular autograft and an external jugular and facial vein with veins of a fibular autograft with further draining and closing of wounds. Besides, in addition to subperiosteal wedge-shaped osteotomy of fibular autograft, its subperiosteal transverse osteotomy is performed to obtain a proximal fragment of fibular autograft 3–5 cm long, a middle fragment length of 3–6 cm and a distal fragment with length of 3–7 cm. An angle of lower jaw is formed, fixing between at angle of 110–120° proximal and middle fragments. That is followed by a longitudinal osteotomy of the distal fragment at angle of 10–15°. A distal fragment of a fibular autograft is rotated through 180° and fixed to lower surface of middle fragment. Modeled fibular autograft is placed in receiving bed. A double fragment of the fibular autograft obtained from the distal and middle fragments is fixed to the lower jaw body, and the proximal fragment – to the stump of the lower jaw, the wound is drained and closed.

EFFECT: method enables simultaneous elimination of body defects and mandibular branches by revascularized fibular autograft with restoration of mandibular body height, lower jaw contour and complete aesthetic rehabilitation of the patient.

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