METHOD FOR DELAYED HYBRID RECONSTRUCTION OF EXTERNAL NOSE WITH HELP OF DUPLICATED FREE RADIAL AUTOGRAFT AND ADDITIVE PLATE Russian patent published in 2024 - IPC A61B17/76 A61F2/18 A61B6/03 

FIELD: medicine; reconstructive surgery.

SUBSTANCE: group of inventions can be used in oncology, traumatology, orthopedics. Based on the CT and MSCT data of the head and neck with a slice thickness of 0.2 mm, 3D model of the structures of the region of interest is constructed. Personified metal additive plate is modeled and printed on 3D printer. Recipient vessels of the region of interest are searched for and prepared. Bed for the additive plate is prepared. Subcutaneous tunnel is formed to bring the vascular pedicle of the flap to the recipient vessels to form microvascular anastomoses. Radial flap is separated from the forearm, which is sufficient to cover the plate from the inner and outer sides. Flap tissue is wrapped around the additive plate so that the skin surface is directed towards the nasal cavity and outward. Performing de-epidermization of a skin strip with width of 5 mm, adjacent to the distal part of the additive plate structure, in a strip of de-epidermized tissue, two perforations are formed for passing through them of the middle and lower right legs of the structure. Additive plate is fixed to the bone structures of the area of interest with the help of screws made of the same alloy as the additive plate and having diameter of 1.5 mm and length of 4–5 mm. Upper legs of the plate are attached to the frontal bone, the middle ones to the zygomatic ones, the lower ones to the maxillary ones. Gap of 5–7 mm is formed between the plate and bone structures. Vascular pedicle of the flap is brought out through the previously formed subcutaneous tunnel. Anastomoses are formed with recipient vessels. Blood flow is started, wound is closed in layers and drained. Method is realized by a device—an additive plate made by printing on 3D printer on a personified model from Ti-6Al-4V alloy, imitating the shape of the nose, 0.6 mm thick. Additive plate has perforations throughout its area with diameter of 1 mm and a distance between perforations of 1 mm and 6 bent legs with holes for screws with diameter of 1.5 mm for fixation on bone structures. Leg bend angle is formed individually for each patient depending on the nature and size of the defect, as well as anatomical features of a particular patient.

EFFECT: group of inventions enables to obtain a satisfactory functional and aesthetic result in one stage when performing total reconstruction of external nose, reduces risks of unfavorable outcomes.

2 cl, 9 dwg, 1 ex