Minsk, Belarus
employee
Ufa, Ufa, Russian Federation
employee from 01.01.2004 until now
Ufa, Ufa, Russian Federation
employee from 01.01.1981 until now
Ufa, Ufa, Russian Federation
Predmet. Poshagovoe opisanie rekonstruktivnoy heyloplastiki u detey s odnostoronnimi raschelinami verhney guby. Cel'. Opisat' principy rekonstruktivnoy heyloplastiki pri odnostoronney rasscheline verhney guby dlya uluchsheniya kachestva esteticheskih i funkcional'nyh parametrov lica u detey. Metodologiya. Za poslednie 8 let provedeno 515 heyloplastik detyam s odnostoronnimi raschelinami verhney guby. Sredniy vozrast sostavil 3,7 mesyaca (mal'chikov — 61 %, devochek — 39), sredniy ves pacienta — 6,3 kg. Operaciyu provodili, opirayas' na 8 principov, neobhodimyh dlya rekonstrukcii odnostoronnih rasschelin verhney guby: ustanovka simmetrichnogo i proporcional'nogo luka Kupidona; sozdanie polnogo sredinnogo bugorka i adekvatnoy vysoty suhoy slizistoy krasnoy kaymy; sozdanie kolonki fil'truma, analogichnoy forme i vysote kolonki fil'truma na zdorovoy storone; sozdanie normal'noy, bez rubcevaniya kolyumelly i ustanovka simmetrichnogo kollyumelyarno-lyabial'nogo soedineniya; pereorientirovka i vosstanovlenie nepreryvnosti krugovoy myshcy rta; sozdanie adekvatnoy gubnoy borozdy; korrektirovka deformacii kryla nosa na storone rasscheliny; ushivanie kozhi atravmatichno, ne lineyno. Rezul'taty. Pri odnostoronnih rasschelinah guby luk Kupidona smeschaetsya vverh, s ukorocheniem guby na storone rasscheliny, krugovaya myshca vpletaetsya v osnovanie kryla nosa na storone rasscheliny, harakterny korotkaya kolyumella s ee deviaciey i nedorazvitiem, uploschenie kryl'nogo hryascha i smeschenie kryla nosa v nizhnelateral'nom napravlenii, a takzhe deviaciya kaudal'noy chasti peregorodki v zdorovuyu storonu. S pomosch'yu nashey metodiki my dostigli bolee horoshego i stoykogo esteticheskogo i funkcional'nogo rezul'tata. Vyvody. Na segodnyashniy den' suschestvuet mnozhestvo metodik i ih modifikaciy rekonstruktivnyh operaciy pri vrozhdennyh rasschelinah guby. Hirurgicheskoe lechenie zavisit ot mnozhestva detaley, kotorye imeyutsya v kazhdom periode: predoperacionnom, intraoperacionnom i posleoperacionnom. Ispol'zuemaya nami tehnika soderzhit v sebe bazovye koncepcii ot kazhdogo ranee opisannogo metoda, rezul'tatom ee primeneniya yavlyaetsya sozdanie stoykoy simmetrii guby i nos.
rasschelina verhney guby, heyloplastika, hirurgiya guby
1. Bessonov S. N. [Anthropometric analysis of the face in the surgery of congenital clefts of the upper lip]. Stomatologicheskie zabolevaniya u detej (ehpidemiologiya, profilaktika i lechenie) = Dental diseases in children (epidemiology, prevention and treatment). Tver, 2000, pp. 160–162. (in Russ.)
2. CHujkin S. V., Topol’nickij O. Z. Lechenie vrozhdennoj rasshcheliny guby i neba [Treatment of congenital cleft lip and palate.]. Moscow, Moscow Publishing House, 2017, 584 p.
3. Meara J. G., Andrews B. T. Unilateral Cleft Lip and Nasal Repair: techniques and principles. Iran J. Pediatr, 2011, vol. 21, no. 2, pp. 129–138.
4. Millard D. R., Latham R., Huifen X., Spiro S., Morovic C. Cleft lip and palate treated by presurgical orthopedics, gingivoperiosteoplasty, and lip adhesion (POPLA) compared with previous lip adhesion method: a preliminary study of serial dental casts. Plast Reconstr Surg, 1999, vol. 103, pp. 1630–1644.
5. Papadopoulos M. A., Koumpridou E. N., Vacalis M. L., Papageorgiou S. N. Effectiveeness of pre-surgical infant orthopedic treatment for cleft lip and palate patients: a systematic review and meta-analysis. Orthod Craniofac Res, 2012, no. 15, pp. 207–236.
6. Chuykin S. V., Davletshin N. A., ChuykinO. S., Bilak A. G., Dzhumartov N. N. Algorithm for rehabilitation of children with congenital cleft lip and palate in regions with unfavorable ecological factors of environment. Book of abstracts 9th World Congress of the Palate Foundation, 31 August-04 September, 2015, Moscow, Russia-I. M. Sechenov First Moscow State Medical University, 2015, pp. 85–86.
7. Chuykin S. V., Davletshin N. A., Chuykin O. S., Bilak A. G., Dzhumartov N. N. Epidemiology, clinical and anatomic form of congenital cleft lip and palate in the region from the petrochemical industry. Book of abstracts 9th World Congress of the Palate Foundation, 31 August-04 September, 2015, Moscow, Russia-I. M. Sechenov First Moscow State Medical University, 2015, pp. 55.
8. Groeper K., Johnson J. O., Braddock S. R. Anaesthetic implications ofNager syndrome Text. Paediatr. Anaesth, 2002, vol. 12, no. 4, pp. 365–368.
9. Wellens W., Vander Poorten V. Keys to a successful cleft lip and palate team Text. B-ENT, 2006, vol. 2, suppl. 4, pp. 3–10.
10. Ysunza A. Physiology of pharyngeal muscles after surgical restoration of the velopharyngeal sphincter Text. Gac. Med. Mex, 2005, vol. 141, no. 3, pp. 195–199.
