Reconstructive surgery of thefacial nerve (step-by-step modeling of the technique using cadaveric materials)

Abstract

The study objective is to develop and test on cadaveric materials a new technique for reinnervation of facial muscles at an early stage from the moment of paralysis occurrence for introduction into neurosurgical practice. Materials and methods . Eighteen (18) fresh non-embalmed cadavers (10 men and 8 women, ages between 18 and 67 years without pathology of the craniomaxillofacial area) were used. During the intervention, a cadaver was put on its back, access to the area of interest was performed in esthetically insignificant areas. For plastic surgery of the facial nerve, the masseteric branch of the trigeminal nerve and the subtotal hypoglossal nerve, calf sural nerve and great auricular nerve autotransplants were used as donor material. Results . The presented technique inflicts minimal damage to the patient during autotransplant collection as no functionally significant structures are affected. Conclusion . It is anticipated that in clinical practice the technique will result in movement of the mimic muscles of the upper and middle areas of the face (closure of the eyelids, raising of the eyebrows, etc.) concurrent with swallowing, because upper group of the facial nerve branches is reconstructed using the hypoglossal nerve. Mimic movements of the lower part of the face (smile, lip pursing, teeth baring, etc.) will be performed during teeth clenching as lower group of the facial nerve branches are repaired using the masseteric branch of the trigeminal nerve.