EXTENDED ENDOSCOPIC FRONTOTOMY METHOD Russian patent published in 2021 - IPC A61B17/24 A61B18/22 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely otorhinolaryngology. Bayonet tweezers with two jaws are used. Under the control of a 0 degrees endoscope, one branch of bayonet tweezers is introduced into the nasal cavity through the left half. The second branch is placed on the skin of the pyramid of the nose and advanced distally. The inner branch is led along the upper wall of the nasal cavity along the nasal septum, and the outer branch along the skin of the pyramid of the nose to the nasion. After reaching the external branch of the nasion forceps, the position of the internal branch of the forceps is assessed, which will indicate the projection area of ​​the anterior wall of the frontal sinus and, accordingly, the anterior border of drilling. The inner branch of the tweezers is pressed into the mucous membrane of the nasal cavity and by pressing the tip of the branch on the mucous membrane, a hole is made in it. The forceps are displaced laterally to the medial corner of the eye and the position of the internal branch of the forceps, which will indicate the anterolateral border of drilling, is fixed. The front border of drilling through the opposite half of the nose is determined in a similar way. By pressing the tip of the branch on the mucous membrane, a hole is made in it, marking the border point on the mucous membrane. With a scalpel, an incision is made in the mucous membrane of the roof of the nasal cavity at the points marked with tweezers, with the formation of the anterior drilling line. Then descend to the nasal septum, forming a window in its upper sections, retreating anteriorly from the drilling border by 5 mm, down to the level of the lower edge of the middle shell and posteriorly to the anterior edge of the middle shell and up to the roof of the nasal cavity. After separating the mucous membrane and exposing the bone, the edge of the mucous membrane of the anterior roof of the nasal cavity becomes the front line of drilling. With the help of a diamond nasal bur, the bone is drilled along a previously defined drilling line, moving from side to side. Sawing off the bone leads to the exposure of the lumen of the right and left frontal sinuses at the level of their anterior wall.

EFFECT: method makes it possible to carry out the intervention without the use of a navigation system, to more accurately determine the anterior border of drilling the bottom of the frontal sinuses, to increase the efficiency and safety of extended endoscopic frontotomy.

1 cl, 2 dwg, 1 ex