METHOD FOR SINGLE-STAGE ELIMINATION OF BONE AND SOFT TISSUE DEFECTS OF MAXILLOFACIAL AREA Russian patent published in 2021 - IPC A61B17/24 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery. Bone and soft tissue defects of the maxillofacial region are eliminated by distributing the defect bed from transfacial access in different planes. After exposing the bone fragments of the jaw, a facial artery, a front vein and an external jugular vein are excised in the submandibular region. Fibular autograft is lifted. From a vertical incision in a projection of a fibular bone separation of an intermuscular partition between an inferior and soleus muscles is performed. Thereafter, the outer surface of the fibular bone is exposed. Front muscle group is prepared. Interosseous septum is detected and dissected. Posterior muscle group is prepared. Vascular bundle, a fibular artery and two veins are visualized. Adipofascial area is separated from the skin at the level of the perforating vent in accordance with preoperative planning. Autograft is modelled according to stereolithographic patterns prepared by intraoperative patterns. In places of planned osteotomy, periosteum and soft tissues are stripped minimizing their damage. Subperiosteal wedge-shaped osteotomy is performed. Obtained fragments are fixed between themselves at angle of 110–120 degrees, thereby obtaining the missing portion of the jaw with the fat component on the perforating vein from the fibular artery. After the vascular bundle is cut off in the donor zone with the autograft, a bone defect of the jaw is simultaneously replaced, as well as a soft tissue defect by adding and distributing an adipofascial platform of a fibular flap on a perforating vertebral artery from the transfacial approach in a prepared cavity. Bone portion of the autograft is fixed to the jaw stump using titanium mini-plates and mini-screws. Soft-tissue component is represented by an adipofacial flap combined with a bone autograft on a perforating vein from the fibular artery separated from a muscle thickness - a long flexor muscle of the thumb and rotated into a pre-created subcutaneous fat pocket.

EFFECT: method allows simultaneous elimination of bone and soft tissue defects of maxillofacial area, restoration of lower jaw contour, volume of soft tissues of adjoining areas and aesthetic rehabilitation of patients with maxillofacial defects.

1 cl, 1 ex