METHOD OF ELIMINATION OF PARALYSIS OF MIMIC MUSCLES Russian patent published in 2023 - IPC A61B17/00 

FIELD: medicine; plastic surgery; maxillofacial surgery.

SUBSTANCE: incision is made on the affected side starting from the scalp of the temporal region, continuing in the anterior region anteriorly from the tragus to the earlobe. After that, the skin-fat flap is mobilized, the superficial temporal arteries and veins are visualized in the temporal region, the masticatory branch of the trigeminal nerve is verified and isolated in the area of the mandibular notch in the thickness of the masticatory muscle, the masticatory branch of the trigeminal nerve passes through a blunt path to the nasolabial fold area, and a bed for the autograft is formed in the parotid — masticatory, temporal region and commissure region of the mouth. An arcuate incision is made on the non-affected side, starting from the scalp of the temporal region, continuing in the anterior region anteriorly from the tragus to the earlobe, the skin-fat flap is mobilized, the buccal branch of the facial nerve is isolated by blunt dissection, then the sural nerve autograft is taken. An autoinsert from the sural nerve is made using a neuroconductor from the vestibular surface of the upper lip, the sural nerve is dissected using a microsurgical technique of 0.5 in diameter of the buccal branch of the facial nerve of the non-affected side, the previously performed autograft of the sural nerve is sutured to the buccal branch of the facial nerve of the non-affected side. After that, an autograft of the sternohyoid and scapular-hyoid muscles with a neurovascular bundle is taken, using access through a skin incision along the anterior edge of the sternocleidomastoid muscle, a fragment is included in the autograft of the sternohyoid and scapular-hyoid muscles body of the hyoid bone. The autograft of the sternohyoid and scapular-hyoid muscles is located in the previously prepared bed as follows: the upper end of the autograft of the sternohyoid and scapular-hyoid muscles, namely, a fragment of the body of the hyoid bone, is fixed in the zygomatic region, the lower end is fixed in the area of the corner of the mouth and nasolabial folds, vascular anastomoses are applied between the superior thyroid artery and vein and the superficial temporal artery and vein, respectively, then nerve anastomoses are applied between the end of the autograft nerve with the masticatory branch of the trigeminal nerve of the affected side and the second end of the sural nerve autograft. The edges of the wound are pushed together and sutured in layers.

EFFECT: method allows to bring in an additional number of motor neurons, and also allows to achieve symmetrical movements on the affected and non-affected sides of the face, which improves the aesthetic and functional results.

1 cl, 2 dwg, 1 ex