MIMIC MUSCLES REINNERVATION METHOD Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial, reconstructive and plastic surgery. Skin and subcutaneous fat are dissected on an affected and healthy sides with preauricular and postaural approach. Further, along the hair growth line, the adipodermal flap is dissected to the front edge of the parotid gland with subsequent release of the muscular-aponeurotic layer. Posterior edge of parotid gland is separated and mobilized from cartilaginous part of external ear: tragus, antitragus and intertragic notch. On the affected side, the facial nerve is isolated and cut off within the exit of the stylomastoid foramen and the parenchyma of the parotid glands is excised. Further, the trunk and branches of the facial nerve are separated in the parotid gland and the facial nerve is divided into an upper part with temporal, malar and cheek branches and a lower portion with marginal and cervical branches. Then in the area of an apex of the digastric muscle, a sublingual nerve is extracted and 30–40 % of its fascicles are incised, then a fascial sleeve of the masticatory muscle is dissected, its fibers are expanded, reaching the semilunar notch, the masticatory branch of the trigeminal nerve in it is cut as much as possible to the zygomatic arch. That is followed by sampling 30–36 cm long autograft that is divided into three lengths 20–25 cm, 6.0–6.5 cm and 4.0–4.5 cm. 20–25 cm long autograft nerve segment is carried out from the affected side to the healthy under the previously isolated adipodermal flap through the oral cavity under the mucous membrane, and the end of a segment of the sural nerve autograft of 6.0–6.5 cm long is stitched with a sublingual nerve, the end of a segment of the sural nerve autograft of length 4.0–4.5 cm is stitched together with a masticatory branch of the trigeminal nerve. Other end of this segment is sutured with the lower part of the facial nerve. Other end of the autograft nerve segment of 6.0–6.5 cm length is sutured on the affected side with the temporal and buccal branches of the facial nerve. Further, an anterior edge of the parotid gland is separated by a malar branch of the facial nerve with subsequent dissection thereof and sutured to the end of the autograft nerve of 20–25 cm length. Then, on the healthy side of the anterior edge of the parotid gland, a malar branch of the facial nerve is separated, followed by dissection of 0.4–0.5 cm of its diameter and sutured together with the other end of an autograft nerve in length of 20–25 cm with subsequent soft tissue suturing.

EFFECT: method allows performing isolated movements of the middle and lower face zones in the patients with facial muscle paralysis.

1 cl, 1 dwg, 2 ex