METHOD FOR SURGICAL CORRECTION OF THE CONSEQUENCES OF FACIAL NERVE INJURY AFTER RADICAL OPERATIONS IN PATIENTS WITH TUMORS OF THE HEAD, NECK, POSTERIOR CRANIAL FOSSA AND EXTRACEREBRAL TUMORS OF THE SKULL BASE Russian patent published in 2021 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to oncology, surgery, plastic surgery and ophthalmology. Treating the skin and mucous membranes with antiseptics, marking skin incisions, performing local or general anesthesia; then, arcuate converging skin incisions are performed in the superciliary region, while the lower incision is made along the edge of the hairy part of the eyebrow, and the upper incision is accordingly performed, departing from the lower incision 1.5-2.0 cm, depending on the degree of eyebrow drooping in the patient. Wherein the healthy side of the face serves as a reference point for determining the width of the excised flap. Then the skin flap formed between the incisions is excised, and the resulting defect is sutured with cosmetic sutures. Next, a spindle-shaped incision of the skin of the upper eyelid is performed along the fold line of the upper eyelid, starting from the medial corner of the eye outward to the frontal projection of the hairy part of the eyebrow, respectively, while the excess skin is excised with the removal of excess orbital fatty tissue, the resulting defect is sutured with cosmetic sutures. Then, a through wedge-shaped resection of the skin, cartilage and conjunctiva of the lower eyelid is performed with the base directed to the marginal edge of the lower eyelid, 5 to 10 mm wide, depending on the degree of eversion of the patient's lower eyelid, layer-by-layer wound closure is performed. Next, the outer corner of the eye is raised by performing a skin incision along the ciliary edge of the lower eyelid, starting from its middle outward to the outer corner of the eye, which is continued horizontally until the projection of the outer edge of the orbit, the lower skin flap is separated from the circular muscle of the eye along the entire incision with a height of 8 mm. At the same time, the external ligament of the eyelids is exposed, which is crossed at the point of attachment to the orbit and sutured to the periosteum of the orbit above the commensurate level of the healthy side by 1-3 mm with non-absorbable sutures, and the resulting skin defect is sutured with cosmetic sutures.

EFFECT: method allows providing the possibility of correcting the consequences of damage to the facial nerve at later stages after the end of specialized treatment (chemoradiation therapy) in the presence of scarring of post-radiation fibrosis and atrophy of the facial muscles with the achievement of satisfactory aesthetic and functional results, ensuring the possibility of low trauma of surgery, which can be performed under conditions of local anesthesia, performing correction in patients when reinnervation technologies cannot be applied technically, without the use of expensive microsurgical equipment, to ensure the possibility of repeated corrective interventions, regardless of the severity of the scar process, post-radiation fibrosis.

1 cl, 2 ex, 6 dwg