METHOD FOR MICROSURGICAL RECONSTRUCTION OF FACIAL NERVE Russian patent published in 2025 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to maxillofacial and reconstructive plastic surgery. Approach is performed in a parotid-masticatory region to a shaft and branches of a facial nerve according to Kovtunovich by means of a vertical incision of skin and subcutaneous fat. Incision extends from the hairy part of the temporal region anterior to the auricle. Further, the incision passes at the earlobe into the behind-the-ear region and extends upwards and backwards from the auricle along the natural behind-the-ear skin fold to the level of the base of the mastoid process of the temporal bone. Further, the incision is turned down and performed in a projection of the anterior edge of the sternocleidomastoid muscle to the angle of the lower jaw. Adipocutaneous flap is mobilized to the level of the anterior edge of the parotid saliva with subsequent exposure of the superficial muscular-aponeurotic layer (SMAL). Then SMAL is dissected parallel and below lower edge of zygomatic arch by means of blunt dissection of soft tissues in parotid-masticatory area. Transected branches of the facial nerve are identified and separated. Length of the detected facial nerve defects is measured. Fascicular rotated flap is separated in a temporal-facial portion of a facial nerve within a parotid salivary gland. Fascicular flap of a cervicofacial portion of a facial nerve is formed before its division into a marginal and a cervical branch. Flap is lifted with an incomplete transverse incision of the facial nerve fibre. Axial incision is made, the length of which corresponds to the measured length of the facial nerve defect. Then the produced fascicular portion of the facial nerve is rotated by turning the fascicles extending from the proximal or distal stump of the injured nerve into the defect area. After approximation of nerve ends using microsurgical technique, end-to-end co-optation is performed and 2 interrupted sutures are applied between fascicular portion of donor facial nerve and recipient part of injured nerve. Postoperative wound in the receiving bed of the parotid-masticatory region is closed in layers.

EFFECT: method allows to achieve satisfactory functional results in microsurgical reconstruction of facial nerve, to reduce injuries due to absence of need for donor nerve sampling, to preserve flap vascularization, to reduce operation time.

1 cl, 5 dwg, 2 ex