METHOD OF DECOMPRESSING EPITHELIAL CYST OF JAW IN DENTITION AREA Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine, maxillofacial surgery.

SUBSTANCE: invention is intended for use in the surgical treatment of epithelial cysts of the jaw in the dentition area. Access to the internal volume of the cyst is provided from the oral mucosa. The following is performed: a cone-beam computed tomography of the head with the help of which the location of the cyst is specified, and then the optimal path of access to the cyst cavity from the oral mucosa is determined and recorded, namely: from the starting point on the oral mucosa to the point of opening the cyst cavity in access site, measure the length of the optimal access path into the cyst cavity and record the result. After that, in an industrial 3D modeling system, virtual modeling of drainage for decompression of the cyst is performed in the form of a tubular cylindrical segment, the ends of which are equipped along the perimeter with a continuous side, forming a single whole with the cylindrical segment and bent outward at a right angle to the generatrix of the cylindrical segment, which is modeled with length between the sides equal to the measured length of the optimal access path to the cyst cavity from the side of the oral mucosa, with a wall thickness of 1 mm and an internal diameter, which is the diameter of the drainage outlet, of 2–3 mm, and the sides are modeled with a width of 1 mm and a height 1 mm relative to the outer surface of the cylindrical segment. Then, using the virtual drainage model, a virtual modeling of the template is performed for the manufacture of physical drainage by casting, while the template is modeled in the form of two identical hollow forms with an internal surface congruent to the outer surface of half of the virtual drainage model, formed by a plane passing through the longitudinal axial line of the cylindrical segment. The outlet hole former, a cylindrical liner, is modeled with a length exceeding the length between the ends of the cylindrical section, and with a diameter equal to the diameter of the drainage outlet hole, while in the template forms, the recesses in the shape of a semicircle with a radius that ensures that the ends of the cylindrical liner are placed in them with force. Then, using the obtained virtual models of the template and the cylindrical liner, a physical template and a physical cylindrical liner are manufactured using 3D printing technology. Then a physical drainage is made from silicone to decompress the cyst, for which the template molds are completely filled with liquid silicone. Then a cylindrical liner is placed in one of the template forms, the ends of which are placed in the recesses made in the template, after which both halves of the template are connected, fixed and held until the silicone hardens. After that the finished drainage is removed from the template molds and the cylindrical liner is pulled out of the drainage, then access to the cyst cavity is made from the side of the oral mucosa along the fixed optimal access path from the starting point on the oral mucosa through the point of opening the cyst cavity at the access site, opened cyst. Then, aspiration of the cyst contents and medicinal treatment of the inner shell of the cyst are performed, after which a drainage is installed, moving its side forward into the cyst cavity from the side of the oral mucosa along the access made, while the side of the distal end of the cylindrical section of the drainage is brought inside the cyst shell and pressed from the inside to mucous membrane of the cyst, and the side of the proximal end of the drainage segment is fixed on the surface of the mucous membrane of the oral cavity in the area of the starting point of the optimal path of access to the cyst cavity, the drainage is left in the cyst cavity until there is complete absence of discharged exudate from the cyst cavity.

EFFECT: due to the possibility of using drainage made individually, the method allows to increase the duration of the drainage function, provides the opportunity for medicinal treatment of the internal cavity of the cyst without removing the drainage, increases the safety and physiology of the method, and also reduces the risk of wound infection during medicinal treatment of the internal cavity of the cyst.

1 cl, 2 ex, 21 dwg