METHOD FOR EXTENDING MIDDLE FACE ZONE USING SYSTEM OF INDIVIDUAL COMPRESSION-DISTRACTION APPARATUSES Russian patent published in 2025 - IPC A61B17/66 A61B6/03 A61C7/02 A61B6/51 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery, reconstructive and plastic surgery. Before the surgical treatment, the patient undergoes a CT examination, and the obtained images are used to determine the extension of the nasal-zygomatico-orbital complex and upper jaw. Orthodontic preparation consists in fixation of dental arches with the help of external bracket system. Then, based on the obtained CT images, the distance and direction of movement of the midface bone fragments are determined using cephalometric analysis. Obtained data are used to simulate a skull surface, an individual configuration and a layout of compression-distraction apparatuses (CDA). Individual CDA are made. 3D printer is used to model the patient’s skull in STL format for precision positioning of said CDA. That is followed by a surgical intervention involving the use of a coronary and vestibular approach to the upper jaw; a modified Le Fort II osteotomy is performed. Osteotomy of the zygomatic arch and the frontal process of the zygomatic bone is performed; the osteotomy line is continued along the lateral and inferior walls of the orbit and further to the piriform opening below the beginning of the inferior nasal concha. Further, using a curved chisel, an osteotomy of the upper jaw cusps is performed from the pterygoid processes of the sphenoid bone. Osteotomy line of the lateral walls of the nasal passages is continued below the inferior turbinate. Then, the extra-osseous CDA plates are fixed with screws in the area of the zygomatic arches and in the area of the frontal processes of the zygomatic bones in the planned areas, the positioning of which was developed on the STL model. Wounds are closed layer-by-layer with interrupted sutures, leaving outside a rod with hexagonal head for socket wrench. In 5-10 days after the operation, the CDA is activated, during which the osteotomised fragment of the midface bone is displaced according to the preliminary planning by turning the end key. When the planned degree of midface protrusion is achieved, the result is assessed by the control MSCT of the maxillofacial region and based on the cephalometric digital analysis, and if the result is satisfactory, the CDA is taken.

EFFECT: method allows to achieve predicted protrusion of middle one-third of face with realization of distraction in three planes, to obtain good aesthetic and functional result in surgical treatment of hypoplasia of middle zone of face in patients with congenital malformations of maxillofacial area.

1 cl, 1 ex, 16 dwg