METHOD OF ULTRASONIC OSTEOPLASTY FOR WIDE NASAL DORSUM Russian patent published in 2024 - IPC A61B17/24 A61N7/00 A61B18/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to plastic surgery and otorhinolaryngology. Open approach is used to mobilize and elevate soft tissues within the inferolateral cartilages in the plane above the superficial muscular-aponeurotic system of the nose. It is followed by mobilization and elevation above the superlateral cartilages supraperichondrium and in the region of the bone 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. Thereafter, ultrasonic osteoplasty is performed on both sides of the bone pyramid, and bone thickness is first removed in the area of the lateral part of the bone pyramid, then in the area of the central part of the bone pyramid. Then, using a piezoelectric instrument, the bone cap is removed and the cartilaginous fornix is exposed in the cranial direction. Paramedial ostectomy is performed, and a strip of the central portion of the bone pyramid is removed. Transverse osteotomy is performed. Then, an incomplete lower lateral osteotomy is performed, and an intact portion of the bone pyramid is left between the lines of the lower lateral and transverse osteotomies. In the caudal part of the bone pyramid, the side walls are fixed to each other through two drilled holes with a suture. Cartilaginous hump is shaved off with a scalpel while preserving the intact mucosa. Through incisions of the perichondrium from both sides on the caudal edge of the septum, the perichondrium is mobilized, and a cartilage graft is taken for cartilage grafts with leaving an L-shaped frame. Then the cartilage grafts up to 20 mm long are fixed on both sides to the caudal edge of the septum, and between them a septum-extending cartilage graft is fixed, to which the medial crusts of the wing cartilages are fixed on both sides. New domes are created by oblique suturing on the tip of the nose and fixed to each other.

EFFECT: method makes it possible to perform narrowing of nasal dorsum by means of ultrasonic osteoplasty with carrying out osteotomy and preservation of intact section of bone pyramid between lines of osteotomy, preserve respiratory function, reduce operative injuries, reduce postoperative oedema, periorbital ecchymosis and postoperative pain syndrome.

1 cl, 2 dwg, 1 ex