METHOD FOR ELIMINATION OF DEFECT OF ORAL CAVITY MUCOUS MEMBRANE Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to oncology, plastic surgery, maxillofacial surgery, dentistry, rehabilitation medicine. Performing the skin-fascial displaced flapping on the vascular pedicle in the genian and the submandibular region, removing the primary focus, lymphodissection on the side of the primary tumor with subsequent replacement of the defect in the oral cavity with a graft of the graft. Diameter and location of facial artery are evaluated by ultrasonic examination. Intraoral access is used to remove the primary focus, marking out the contour of the skin-fascial flap in the submandibular area of the ellipsoidal shape, wherein the upper edge of the flap is the lower edge of the body of the lower jaw, and the middle point of its upper boundary is the point of intersection of the facial artery of the lower jaw body, the lower border is the hyoid bone body level. Further, in the submandibular region, a skin incision is made along the lower outline of the graft marking, according to fig. 1, including a hypodermic neck muscle in the transplant. Flap is lifted to the lower edge of the mandibular body; the skin is incised along the upper contour of the flap in the projection of the facial vessels only to subcutaneous fat. Further, the skin is lifted 2 cm higher from the lower edge of the lower jaw body and 1–2 cm away from the facial artery and vein. Facial vessels are transected and ligated distally 2 cm from the lower edge of the lower jaw body, then a skin incision is made along the upper contour of the flap to a subcutaneous muscle of the neck inclusively. Marginal branch of the facial nerve is completely separated and a flap is exposed under it; the vascular pedicle of the flap is mobilized to the edge of the skin site. Then blunt and acute path of skin-fascial flap is peeled from surrounding tissues and flap is formed, which includes skin, subcutaneous fat, subcutaneous muscle of neck and soft tissue clutch around facial artery above lower edge of lower jaw body. Performing lymphadenectomy on neck, from submandibular region to area of oral cavity defect, tunnel is formed, and through it, by rotation method, flap is placed in the defect area and fixed with vicryl 4.0 threads to the surrounding tissues, after which the formed defect of the submandibular region is eliminated with local tissues.

EFFECT: disclosed method enables to close defects arising in surgical treatment of oral mucosa cancer and reduce length of rehabilitation in postoperative period; provide maximum plastic congruity by using a flap without including an anterior abdomen of the digastric muscle and mandibulohyoid muscle; improving the aesthetic effect and minimizing damage to the donor area.

1 cl, 1 ex, 4 dwg