METHOD OF RECONSTRUCTING THE BACK OF THE NOSE IN CONGENITAL MALFORMATIONS IN CHILDREN Russian patent published in 2023 - IPC A61B17/24 A61M25/00 A61K31/00 A61K9/06 A61P31/04 

FIELD: medicine; otorhinolaryngology; reconstructive and plastic surgery.

SUBSTANCE: under intubation anesthesia and infiltration anesthesia, a catheter filled with a brilliant green solution is inserted into the fistulous tract to the pathological formation located in the back of the nose. Then, an elliptical incision of the skin and subcutaneous fat is performed around the fistulous opening. The incision of the skin and subcutaneous fat is continued along the fistulous tract, visualized by means of the inserted catheter. After that, the walls of the fistulous tract and the formation capsule are separated from the surrounding tissues along the entire length, without damaging the integrity of their walls. Then, in the region of the columella and the bottom of the nasal cavity, an incision is made along the transitional fold on the left, and the mucoperichondria and mucoperioste of the nasal septum are separated with a raspator along the entire length, providing endonasal access to the formation. Through the incision, the formation capsule is also separated from the surrounding tissues without damaging it. After complete separation, the fistulous tract is completely excised. Under the control of endoscopic technique, a control examination of the nasal cavity is performed up to the posterior wall of the frontal sinus in order to revise the remains of the pathological formation. After that, the reconstruction of the back of the nose is performed by mobilizing the nasal bones, bringing them together and fixing them using suture material. Layer-by-layer suturing of the wound from the outside is carried out with the installation of drainage with output to the outer surface of the nose in the area of the excised outlet of the fistulous tract and the second drainage with output to the nasal cavity through the counter-opening formed by dissection of the mucoperichondria at the transition site of the cartilaginous section of the nasal septum to the bone. Then the mucous membrane is sutured in the area of the vestibule of the nose. Latex swabs lubricated with antibacterial ointment are placed in the nasal cavity.

EFFECT: method allows to radically excise the pathological formation, and to exclude the development of relapses.

1 cl, 10 dwg, 3 ex