METHOD AND DEVICE FOR RECONSTRUCTION OF LOWER ORBIT WALL AND ENOPHTHALMOS ELIMINATION

摘要

FIELD: medicine.;SUBSTANCE: group of inventions relates to medicine, namely to ophthalmology and maxillofacial surgery, and is intended for the reconstruction of the lower orbit wall and elimination of enophthalmos. A cut is performed on the transition fold of the maxilla from 2-nd to 6-th tooth or a cut is performed in the intraorbital region on the lower fold of the eyelid. Skin is separated from the circular muscle to the infraorbital edge. The infraorbital region and the orbit bottom are skeletonised. An implant is introduced and fixed or osteotomy of the displaced into the sinus lumen lower wall of the orbit on the entire perimeter with its further ablation and replacement with the implant is carried out; or osteotomy of the displaced into the sinus lumen lower wall of the orbit is performed partly on the perimeter with further ablation of damaged fragments and its replacement with the implant; or in case if a defect of the lower wall of the orbit is present, the defect is replaced with the implant. The lower wall of the orbit is fixed with the implant from metal-rubber and wire bars. Fixation of the implant bars is performed in the area of the infraorbital edge and in the area of the maxilla tuber in points from 3 to 10. During the operation dislocation of the eyeball is performed by means of control-rods; or dislocation of the eyeball by means of control-rods is carried out in the post-operation period. Fixation of control-rods is performed by means of intraosseous screws or pins or on-bone clips to the infraorbital edge, and the sinus walls. Metal-rubber is fixed to the bone by means of a suture material or the intraosseous screws or pins or on-bone clips. Anastomosis between the maxillary sinus and the oral cavity is created by suturing a hollow tube to the wound, or two anastomoses are created between the maxillary sinus and the oral cavity and the maxillary sinus and the lower nasal passage by suturing the hollow tube to the wound. The device for the reconstruction of the lower wall of the orbit and elimination of enophthalmos consists of a wire implant in the form of 2 to 5 guiding wire bars and L-shaped metal-rubber in the sagittal projection and an oval shape in the horizontal projection, pierced with bars, correcting the wire control-rods, fixed with one end to the distal part of the implant in the posterior third of the orbit.;EFFECT: group of inventions makes it possible to create the natural anatomical shape of the orbit lower wall implant, create possibilities of intro- and post-operation correction of the shape of the orbit lower wall implant and carry out sagittal dislocation of the eyeball and its horizontal and vertical transposition.;3 cl, 7 dwg, 6 ex