EFFECTIVENESS OF STATIC RECONSTRUCTIVE METHODS IN THE TREATMENT OF LONG-TERM PARALYSIS OF THE FACIAL NERVE
DOI:
https://doi.org/10.11603/2414-4533.2025.3.15623Keywords:
facial asymmetry, fascial flap, musculo-aponeurotic system, faceliftAbstract
The aim of the work: to evaluate the effectiveness of static reconstructive interventions, in particular using a fascial flap of the broad fascia of the thigh, in patients with long-term facial nerve palsy (FNP).
Materials and Methods. The purpose of the study was to comprehensively evaluate the effectiveness of static reconstructive methods in patients with long-term PLN. To achieve the goal, a flap of wide fascia of the thigh was applied, which was fixed to the commissure of the mouth and to the temporal fascia with tunneling through the musculo-aponeurotic system of the face. In addition to the basic interventions, adjuvant procedures – unilateral facelift and correction of the lower eyelid ectropion by lateral tarsal suture were used, which provided an improvement not only in cosmetic but also in functional characteristics. Statistical analysis was performed using Microsoft Excel (Microsoft 365), the significance level was considered at p<0.05. All stages of the study complied with current international ethical standards. Patients signed informed consent, and the study protocol was approved by the Ethics Committee of the Valikhnovski Surgery Institute (LLC "Clinic 311").
Results. The study presents clinical cases of three patients with long-term PLN who underwent reconstructive surgery describing technique, rehabilitation period and outcomes. The obtained data indicate a high level of correction of facial asymmetry –the success rate of interventions reached 97–98 %, which significantly exceeds the indicators of classical dynamic methods (about 50–52 %). Operations were marked by relatively short duration (60–75 minutes), minimal blood loss, and postoperative results remained stable throughout the year of follow-up. The comprehensive approach promoted the activation of the temporalis muscle as the main driver of the mouth angle movement in the absence of facial nerve function.
Conclusions. The findings confirm the high efficacy of static reconstructive techniques in the treatment of long-term iatrogenic PLN, especially in paralysis over 24 months, when dynamic techniques are ineffective due to muscle atrophy. The use of a flap of the wide fascia of the thigh provides a stable correction of the asymmetry of the oral slit and improves the functional and aesthetic condition of patients with minimal complications.
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