METHOD OF ENDOSCOPIC PLASTICS OF NASAL SEPTUM FIXED PERFORATION Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely otorhinolaryngology, and can be used for endoscopic plasty of fixed perforation of nasal septum. Flap is formed on anterior mesenteric arteries. Total of two flaps are produced. Initially, a flap is obtained from an upper portion of a nasal septum. For this purpose, line of incision in 1.5 times longer than maximum horizontal size of perforation of nasal septum is marked parallel to nasal bridge. Further, from the anterior and posterior ends, the line is continued radially towards the center of the septal defect, thus forming the first flap in the form of an inverted trapezoid with a pedicle within the upper edge of the perforation of the nasal septum. Further, a flap is formed on anterior latticed artery. For this purpose, subperiosteal from the incision at the level of the anterior edge of the perforation of the nasal septum the mucoperiosteum is separated from the bottom of the nasal cavity from the vestibule of the nose to the back edge of the palatine plate of the maxillary junction from the front to the back, and laterally to the attachment point of the inferior nasal concha. Tissues are medially separated to a lower edge of the perforation and posterior to the perforation throughout the entire bone portion of the nasal septum to the level of the upper edge of the nasal septum perforation horizontally and the medial edge of the choana posteriorly. Using the scalpel along the above borders, the flap is mobilized with leaving the feeding stem on the meshed arteries back and forth from the perforation of the nasal septum. Then the first flap is rotated from one half of nose to another through the upper edge of perforation of the nasal septum. Second flap is moved in the same half of the nose anteriorly and upwards to close the perforation of the nasal septum and the donor area of the first flap. Interposition of a fragment of temporal auto fascia exceeding the size of the defect by half is performed between the flaps.

EFFECT: method provides higher clinical effectiveness in persistent perforations of nasal septum by using two flaps of mucous membrane on feeding legs of one half of nasal cavity with interposition between flaps of fragment of temporal auto fascia.

1 cl, 3 dwg, 2 ex