METHOD OF TREATMENT OF THE CHRONIC ODONTOGENIC MAXILLITIS COMPLICATED BY THE OROANTRAL FENESTRATION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to the field of medicine, namely to otorhinolaryngology and maxillofacial surgery, and is intended for use in the treatment of inflammatory diseases of the paranasal sinuses, complicated by oroantral fenestration. Produce adrenalization of the nasal passages from the operated side. Infiltrate the main plate of the middle nasal conch, the hook-shaped process with a solution of ultracain. Hook-shaped appendage is resected. Then, the trellised bull is opened and removed, thereby obtaining bone autografts, which are previously cleaned of the mucous component and soaked in 0.9 % saline for subsequent augmentation. After identifying the natural aperture of the maxillary sinus, dilate it with Blakesley's straight forceps towards the back and bottom, followed by antiseptic treatment of the maxillary sinus, endonosal hemostasis, as well as the necessary measures for the prevention of synechia. Preliminary infiltration of the hard palate from the operated side with an anesthetic solution with epinephrine is performed. Produce an L-shaped incision 2–3 mm from the oroantral fistula. Peel and split the palatal flap into the subepithelial vascularized and epithelial flaps with the mandatory preservation of the periosteum. Next, a detachment of soft tissues from the alveolar process of the upper jaw in the area of oroantral fenestration to obtain a tunnel that is sufficient in size to insert bone lamina, previously soaked in physiological saline, a PRF membrane obtained by centrifugation from an autologous patient, as well as subepithelial flap for further fixation of its U-shaped seam according to the type of mattress from the vestibular side. Palatal defect is covered with PRF membranes and an epithelial palatal flap. Stitches that fix both flaps are removed after 6 days.;EFFECT: method allows to reduce by the restoration of adequate drainage and the functioning of the maxillary sinus as a whole the number of relapses, and also to preserve the relief of the alveolar process and the anatomical-topographical relationships of the surrounding soft tissues.;1 cl, 1 ex