METHOD FOR REPLACING ORBITO-ORO-FACIAL DEFECTS WITH COMPLEX COMPONENT FLAP WITH ONE-SINGLE RECONSTRUCTION OF THE LOWER WALL OF THE ORBIT

摘要

The method of replacing orbital-orofacial defects with a complex component flap with simultaneous reconstruction of the lower wall of the orbit, including reconstructive plastic covering of the through face defect with a complex autograft using a microsurgical technique and a titanium plate with a split bone free parietal flap, according to which taken from the formed defect, determine the necessary size and shape of the graft, form a combined skin-muscle-bone a flap consisting of two fragments on a single vascular pedicle (toricodorsal artery and vein), including: a fragment of the latissimus dorsi muscle with a skin site and a fragment of the scalene muscle with a skin site and a fragment of a rib, the vascular leg of the formed flap is clipped and intersected, the flap is transferred the integrity of the hard palate is restored to the defect zone of the orbit-orofacial zone, the musculoskeletal portion of the flap, the alveolar process of the upper jaw is restored to the musculoskeletal portion of the flap, and the integument e facial tissues, the vascular leg of the flap is carried out in the subcutaneous tunnel of the cheek, vascular anastomoses are formed between the torcodorsal vein and the external jugular neck vein of the end-to-end type and the torcodorsal artery of the flap and the external carotid artery of the end-to-end type, a donor wound on the chest wall is sutured, then a titanium mesh transplant of the lower orbital wall is modeled, the implant is placed in the position of the lower wall of the orbit, fixed to the nasal bone and lateral wall of the orbit with mini titanium screws, Further