METHOD OF ULTRASONIC OSTEOPLASTY FOR NASAL SCOLIOSIS Russian patent published in 2024 - IPC A61B17/24 

FIELD: plastic surgery; otorhinolaryngology.

SUBSTANCE: wide subperiosteal dissection and superficial ostectomy are performed. Under general anaesthesia through open access, mobilization of soft tissues is performed over the superficial muscular-aponeurotic system of the nose over the superolateral cartilages suprachrondrially and in the area of the bony pyramid subperiosteally, in the longitudinal direction from the key zone to the root of the nose and in the transverse direction from one ascending frontal process of the upper jaw to the other side. Then, using a piezoelectric instrument, ultrasonic osteoplasty is performed on both sides of the bone pyramid, removing the bone thickness and bone cap and exposing the cartilaginous vault in the cranial direction. On the convex side, a paramedian ostectomy is performed and a strip of the central part of the bony pyramid is removed. Then a transverse osteotomy and an incomplete lower lateral osteotomy are performed on the same side. An intact section of the bone pyramid is left between the lines of the lower lateral and transverse osteotomies. On the concave side, a paramedian osteotomy together with a transverse osteotomy and an incomplete lower lateral osteotomy are performed. An intact section of the bone pyramid is left between the lines of the lateral and transverse osteotomies. The convex wall is shifted inward, and the concave wall is shifted outward. Next, through incisions in the perichondrium on both sides on the caudal edge of the septum, the perichondrium is mobilized and a cartilage graft is harvested for cartilage grafts, leaving an L-shaped frame. A wide expansion graft is then placed on the concave side, extending from the cranial portion of the paramedian osteotomy along the septum and extending 5 mm caudal to the anterocaudal edge of the septum. A short expansion graft is placed on the convex side, extending 5 mm caudal to the anterocaudal edge of the septum. Both expanding grafts are fixed on both sides to the cartilaginous section of the septum and between them a cartilage graft extending the septum is fixed, to which the medial legs of the alar cartilages are fixed on both sides. If necessary, in the most caudal part of the bony pyramid, the side walls are fixed to each other through two drilled holes with a thread, and the domes are formed by applying oblique sutures at the tip and fixed to each other.

EFFECT: eliminating nasal scoliosis while preserving the bone bridge between the osteotomy lines, and obtaining predictable, stable and low-traumatic results in the postoperative period without disrupting the function of nasal breathing.

1 cl, 1 ex, 2 dwg