METHOD FOR RECONSTRUCTION OF EXTENSIVE AND COMPLEX TONGUE AND MOUTH DEFECTS AFTER PERFORMING RADICAL RESECTIONS IN LOCALLY ADVANCED STAGES OF TUMORS Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to reconstructive maxillofacial surgery and oncology. After the oncologic stage of the operation, a facial artery and a vein on the left are prepared from the surrounding tissues and prepared for the microvascular anastomoses application. Cervico-muscular anterolateral hip flap is picked up and modeled according to the size, shape and thickness of the hip adequately to the formed defect, and transferred into the area of the defect of the oral cavity and tongue. Median mandibulotomy is performed. Neural suture is applied between the branch of the lateral cutaneous nerve of the thigh in the skin portion of the flap and the lingual nerve. Then the skin portion of the flap is distributed in the oral cavity. Vascular pedicle of the flap and the motor branch of the femoral nerve of the muscular portion of the flap are brought outside the angle of the lower jaw in the region of the upper one-third of the neck, and freely thereafter, without tension. Further, microvascular anastomoses are applied between the flap vessels and the neck vessels. One arterial and two venous anastomoses are applied by means of an operating microscope, microsurgical instrumentation and Prolene 9-0 suture material. After all vascular anastomoses are applied, blood supply of all graft portions is evaluated. That is followed by hemostasis in the wound. That is followed by a bone metalloosteosynthesisin the mandibulotomy by titanium plates and mini rotors. Thereafter, the muscles of the oral cavity are plasty by placing a muscular portion of the flap within the mouth cavity with fixing one end to the hyoid bone, and the other one to the lower jaw and the area of the skin portion of the flap. Muscular portion of the flap is fixed with Vicryl 3-0 suture material. Further, a neural suture is applied between a motor branch of the femoral nerve coming in a muscular portion of the flap with a sublingual nerve with the help of microsurgical equipment. After performing the reconstructive stage, the blood flow is repeatedly monitored in all portions of the flap and hemostasis is monitored. Wound on the neck is closed with active drainage left.

EFFECT: method enables more effective recovery of motor and sensory innervation in anatomical reconstruction of the tongue, reduced probability of postoperative complications on the part of the reconstruction area.

1 cl, 2 ex