METHOD FOR SINGLE-STAGE COMPLEX SURGICAL TREATMENT OF MIGRAINE AND CORRECTION OF AGE-RELATED CHANGES OF FACE Russian patent published in 2025 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurology and plastic surgery. Vertical skin incision 4 cm long is made in an occipital region. Subcutaneous fat of the occipital region is dissected, an occipital fascia is dissected, and a right greater occipital nerve is visualized. Right greater occipital nerve is mobilized from the arteries and veins, and the veins are transected. Trapezoidal flap is cut out of an occipital aponeurosis. Trapezoidal flap is fixed subneurally. Active drainage is installed through a counteropening in an occipital region. Occipital skin is closed with an intradermal suture. That is followed by similar manipulations with the left greater occipital nerve. After decompression of greater occipital nerves, pinched blepharoplasty of upper eyelids is performed. Medial paraorbital fat packs are approached; excess medial paraorbital fat pads are excised. Subcutaneous dissection of the lower eyelids is performed. Symmetrical vertically oriented incisions with length of 1.5 cm are made in scalp of frontal and temporal regions. Subperiosteal dissection is performed in both frontal regions, the periosteum is transected at the level of an upper edge of both eye sockets. Upper and lower temporal partitions are transected on both sides, in temporal and parietal areas on both sides dissection is performed in layer between temporo-occipital fascia and superficial leaf of deep temporal fascia. Right and left supraorbital and supra-block neurovascular bundles are separated. Thereafter, right and left zygomatic neurovascular bundles are visualized and mobilized. Right and left temporal branches of facial nerves are visualized. Right and left supraorbital and supra-block nerves are mobilized from arteries and veins. Right and left superficial temporal veins are transected and coagulated. Right and left eyebrow wrinkling muscles are mobilized from the frontal bone. That is followed by a bilateral supraciliary approach, performing a foramenotomy of both supraorbital foramens, and forming supraorbital notches. Both supraorbital neurovascular bundles are mobilized, connective tissue bridges between bone edges of supraorbital notches are excised. That is followed by making 1.8 cm symmetrical incisions of the oral mucosa in the vestibule of the oral cavity. Subperiosteal dissection is performed along anterior surfaces of the zygomatic bones and upper jaws with preserving the integrity of the infraorbital neurovascular bundles. Transoral dissection of an orbital septum of a lower eyelid is carried out with bringing down the paraorbital fat pads into the dissection area. Formed approaches are combined by dissecting the periosteum along the upper edge of the anterior two-thirds of the zygomatic arches on both sides with preserving the integrity of the temporal branches of the facial nerves. Flaps of the middle one-third of the face are displaced in an upper-lateral direction. Flaps of the middle one-third of the face are fixed with distant sutures to superficial sheets of deep temporal fascia. Upper one-third of the face flaps are displaced vertically. Flaps of the upper one-third of the face are fixed with intraosseous removable screws to the frontal part of the skull. Interrupted sutures are used to close temporo-parietal fascia from both sides. Eyelid skin and scalp skin are closed by intradermal sutures.

EFFECT: method enables one-stage treatment of migraine and correction of age-related changes, which in the remote postoperative period solves the problem of clinical symptoms of migraine, risks of its recurrence and significantly improves the quality of life of the patients.

1 cl, 1 ex