METHOD FOR ELIMINATION OF FACIAL NERVE DEFECT

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to maxillofacial and plastic surgery. Skin and subcutaneous fat, which passes from the auricle lug downward along the natural prootic skin fold, enveloping the ear lobe and extending upward and backward from the auricle, is incised. Further, a natural postaural skin fold to the level of the base of the mastoid bone, and the unfolding and projecting anterior edge of the sternocleidomastoid muscle to the angle of the lower jaw. Skin-fat flap is formed and cast with exposing the superficial musculo-aponeurotic system, dissection in the layer between the anterior border of the sternocleidomastoid muscle and the posterior border of the parotid salivary gland, from the angle of the lower jaw to the cartilaginous part of the external auditory canal. Facial nerve trunk is removed within posterior abdomen of digastric muscle to point of its intersection. Superficial muscular-aponeurotic system and a capsule of the parotid gland of the parotid gland are separated with separation of the facial nerve branches to their intersection. As a nerve autograft, a shaft and branches of the superficial fibular nerve are used, which are sampled by performing a linear incision of skin and subcutaneous fat at the level of an ankle, passing anterior from the middle of the lateral malleolus with separation of a surface of the nervus fibularis peroneus communis to the level of perforation of the fascia fascia and on the back surface of the foot of two linear incisions of skin and subcutaneous fat with separation of branch of the nervus fibularis peroneus communis with subsequent intersection of the shaft and branches of the nervus fibularis peroneus communis with a fence of the obtained graft of the nervus fibularis peroneus communis. Autograft is placed into a prepared sensory bed in the parotid mastication with neurorrhaphy between the facial nerve trunk and the nervus fibularis peroneus communis autograft trunk, as well as branches of the autograft of the nervus fibularis peroneus communis and branches of the facial nerve with subsequent layer-by-layer closure of the postoperative wounds.;EFFECT: method enables simplifying and reducing traumatism of the surgical intervention and reducing donor damage.;1 cl, 2 ex, 4 dwg