METHOD FOR RECONSTRUCTING TONGUE AND FLOOR OF ORAL CAVITY AFTER GLOSSECTOMY Russian patent published in 2024 - IPC A61B17/24 A61F2/08 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to reconstructive maxillofacial surgery and oncology. Thigh flap is used for reconstruction of extensive and complex defects of tongue and oral cavity. After the oncological stage of the operation, a facial artery and a left vein are isolated from the surrounding tissues and prepared for microvascular anastomoses. Musculocutaneous flap of the thigh is selected and modelled according to the size, shape and thickness of the formed defect. Flap is transferred to the defect of the oral cavity and tongue. Then, the skin portion of the flap is distributed in the oral cavity. Vascular leg of the flap is brought out behind the angle of the lower jaw in the upper one-third of the neck and placed there freely, without tension. Further, microvascular anastomoses are applied between flap vessels and neck vessels. One arterial and two venous anastomoses are applied with the help of a surgical microscope and microsurgical instrumentation, suture material Prolen 9-0. After all vascular anastomoses are applied, blood supply of all flap portions is assessed. Thorough haemostasis is performed in the wound. That is followed by plastic surgery of the muscles of the floor of the mouth by placing the muscular portion of the flap within the floor of the mouth with fixation of one edge to the hyoid bone and the other to the lower jaw and the area of the skin portion of the flap. Muscular portion of the flap is fixed with the suture material Vicryl 3-0. Carried out are fixation and tension of the mesh of warp-knitted structure from biologically inert superelastic nickelide titanium wire with thickness of 60 mcm, having reversible elasticity of 40% and tensile strength of 4,000 MPa, between hyoid bone and lower jaw with suture material Prolen 3-0. After the reconstructive stage of the operation, blood flow in all portions of the flap and haemostasis are controlled. Neck wound is closed, leaving an active drainage.

EFFECT: method enables effective reconstruction of extensive and complex defects of tongue and oral cavity after radical resection in locally advanced stages of tumours of tongue and floor of oral cavity with complete recovery of tissues without development of postoperative complications from the side of reconstruction.

2 cl, 1 dwg, 1 ex