METHOD FOR ELIMINATING PARALYSIS OF FACIAL MUSCLES Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to plastic surgery. The invention relates to medicine, namely to plastic surgery. On the side of the lesion, an anterior incision is made, and an adipodermal flap is mobilized. In the temporal region, the superficial temporal artery and vein are visualized, a passage is made into the area of the nasolabial fold, and a bed is formed for an autograft 95 cm in size. In the cutoff area on the lower jaw, the chewing branch of the trigeminal nerve is isolated. On the healthy side, a preauricular incision is made, an adipodermal flap is mobilized, and the buccal branch of the facial nerve is isolated. Then the sural nerve autograft is taken. Next, the autograft of the sural nerve is carried over with the help of a neuroconductor from injections from the vestibular surface of the upper lip from the affected side to the healthy one. Using microsurgical technology, 0.5-0.75 of the diameter of the buccal branch of the facial nerve on the healthy side is dissected, the previously passed autograft of the sural nerve is sutured to the buccal branch of the facial nerve on the healthy side. On the side of the lesion, a skin incision is made along the anterior edge of the 80 mm long sternocleidomastoid muscle. The anterior edge of the sternocleidomastoid muscle is visualized, retracted posteriorly, the fibers of the scapular-hyoid muscle are dissected in the area of the tendon insert, and the cervical loop is visualized, which is isolated throughout. Next, the site of the beginning of the superior thyroid vein and the superior thyroid artery are visualized, which are then isolated under a microscope magnification in the distal direction until their branches enter the sternohyoid muscle. The sternum-hyoid muscle is isolated towards the hyoid bone to its attachment site and towards the sternum before its attachment. When the flap is cut off at the upper border, the portion of the hyoid bone to which the sternohyoid muscle is attached is cut out and thus included in the flap. The lower edge of the sternohyoid muscle is cut off from the sternum and stitched with U-shaped sutures. Ligation of the vascular bundle in the proximal part is performed. The flap is cut off, transferred to the recipient area. The edges of the wound in the donor area are brought together and sutured in layers. Next, the autograft of the sternohyoid muscle is placed in the prepared bed in the recipient zone in such a way that the upper end of the autograft (a fragment of the body of the hyoid bone) is fixed in the zygomatic region, and the lower end of the sternohyoid muscle is fixed in the corner of the mouth. With the help of microsurgical technology, the autograft of the sternohyoid muscle is revascularized by imposing vascular anastomoses between the superficial temporal artery and the superior thyroid artery in an end-to-end manner and the superficial temporal vein and superior thyroid vein in an end-to-end manner. Reinnervation of the sternohyoid muscle is performed by imposing a nerve anastomosis: the end of the nerve of the autograft is sutured with the masticatory branch of the trigeminal nerve and the second end of the autograft of the sural nerve. The edges of the wound are brought together and sutured in layers.

EFFECT: method makes it possible to achieve symmetrical movements on the affected and healthy side of the face, which improves aesthetic and functional results.

1 cl, 1 ex, 2 dwg