Facial Anatomy Research Articles

Management of fractures involving the mandibular body, parasymphyseal, and subcondylar regions

Background: The mandibular bone plays a crucial role in various aspects of facial anatomy, including digestion, speech, and facial aesthetics. Given its significance in these functions, surgeons must not only address functional aspects but also consider aesthetic concerns during treatment. Mandibular fractures represent a prevalent form of traumatic injury in the maxillofacial region. Despite the existence of established treatment methods that have been in use for a considerable time, untreated fractures and complications following surgery can still significantly impact the patient's quality of life. Purpose: Understand the principles of managing cases of mandibular corpus, mandibular parasymphysis, subcondyle fractures using a combination of Mini Plate and Reconstruction Plate. Case: A 54-year-old man with mandibular parasymphysis fracture Dekstra, corpus mandibular fracture sinistra, subcondyle fracture sinistra, dentoalveolar fracture regions 32-42 accompanied by avulsions 32, 31, 41, 42, and hypertension was reported. Results: The treatment in this case was Open Reduction and Internal Fixation (ORIF). Fixation of the fracture segments with 2 vertical mini-plates on the parasymphysis of the dextral mandible, 1 mini-plate and reconstruction plate on the corpus and subcondyle fracture sinistra. Conclusion: The use of two plates and screws in the parasymphysis of the mandible, one mini-plate and one reconstruction plate in mandibular corpus and subcondyle fractures, resulted in good occlusion with minimal complications.

Three-dimensional video recordings: Accuracy, reliability, clinical and research guidelines - Reliability assessment of a 4D camera.

In addition to studying facial anatomy, stereophotogrammetry is an efficient diagnostic tool for assessing facial expressions through 3D video recordings. Current technology produces high-quality recordings but also generates extremely excessive data. Here, we compare various recording speeds for three standardized movements using the 3dMDface camera system, to assess its accuracy and reliability. A linear and two circular movements were performed using a 3D-printed cube mounted on a robotic arm. All movements were recorded initially at 60 fps (frames/second) and then at 30 and 15 fps. Recording accuracy was tested with best-fit superimpositions of consecutive frames of the 3D cube and calculation of the Mean Absolute Distance (MAD). The reliability of the recordings were tested with evaluation of the inter- and intra-examiner error. The accuracy of movement recordings was excellent at all speeds (60, 30 and 15 fps), with variability in MAD values consistently being less than 1 mm. The reliability of the camera recordings was excellent at all recording speeds. This study demonstrated that 3D recordings of facial expressions can be performed at 30 or even at 15 fps without significant loss of information. This considerably reduces the amount of produced data facilitating further processing and analyses.

Course and Relation of the Facial Vessels-An Anatomical Study.

Background and Objectives: Facial vascular anatomy plays a pivotal role in both physiological context and in surgical intervention. While data exist on the individual course of the facial artery and vein, to date, the spatial relationship of the vasculature has been ill studied. The aim of this study was to assess the course of facial arteries, veins and branches one relative to another. Materials and Methods: In a total of 90 halved viscerocrania, the facial vessels were injected with colored latex. Dissection was carried out, the relation of the facial vessels was studied, and the distance at the lower margin of the mandible was measured. Furthermore, branches including the labial and angular vessels were assessed. Results: At the base of the mandible, the facial artery was located anterior to the facial vein in all cases at a mean distance of 6.2 mm (range 0-15 mm), with three cases of both vessels adjacent. An angular vein was present in all cases, while an angular artery was only present in 34.4% of cases. Conclusions: The main trunk of the facial artery and vein yields a rather independent course, with the facial artery always located anterior to the vein, while their branches, especially the labial vessels, demonstrate a closer relationship.

Diagnostic assessment of jaw bone density in school-age children using chewing gum

Relevance. The article is devoted to the issue of diagnosing the condition of the jaw bone tissue in children with mixed dentition. The relevance of the study is related to the increased consumption of chewing gum by children.The purpose of this study was to evaluate the echodensity of the jaw bone tissue in patients with mixed dentition using chewing gum with varying intensity.Materials and methods. We examined 31 children, the average age was 8.5±1.2 years. It is at this age that the active formation of facial morphology and anatomy takes place, which is directly related to the condition of the jaw bones. For diagnosis, an ultrasound technique was chosen – osteometry. This method is based on assessing the speed of propagation of ultrasound waves along the surface of the bone. In addition, in comparison with radiation, ultrasound methods for studying bone tissue have significant advantages, expressed in the reliability of the results obtained, low cost of procedures, ease of use, absence of radiation for personnel and patients, and minimal research time. From a practical point of view, this method is the most accessible in a dental office. Echoosteometry was carried out using the Echoosteometer EOM-01TS apparatus.Results. Based on the study, it was revealed that there was an imbalance in bone density in children who actively used chewing gum.

The Quadrangular Cartilage in Rhinoplasty: A Surgically Focused CT Dimensional Analysis of Black African and Caucasian Populations.

The apparent lack of quadrangular cartilage in Black African noses is commonly observed both from a radiological and clinical point of view. To the best of our knowledge, only a few research papers have been conducted on the facial proportions and structural anatomy of black people of Southern and Eastern Africa. The aim of this retrospective comparative study is a radiological assessment of the total amount of septal quadrangular cartilage by measuring its area in sagittal CT views, in two selected Black South African and Caucasian (CA) samples and the comparison with the literature in our hands. Statistical analysis was conducted, categorical variables are shown as frequencies and percentages, while continuous variables as means and standard deviations. Normal distribution of variables was verified using the Shapiro-Wilk test or by means of skewness and kurtosis values. Differences among unpaired groups were evaluated using the independent Student's t-test for normally distributed data (complemented by the Cohen's d to show the effect size with the following cutoff: d = 0.2, "small" effect size; d = 0.5, "medium" effect size; d = 0.8, "large" effect size) and Mann-Whitney U test in case of non-normal distribution. Statistical significance was defined as p < 0.05 setting the α-error probability at 5%. This study shows that, on average, there is 30% more cartilage available in CA compared with Black African noses and confirms the apparent lack of quadrangular cartilage and in Black African noses which is commonly observed in surgery. The need for an adequate amount of autologous septal cartilage makes cartilage availability a major concern before surgery and being able to preoperative accurately measure the amount of septal cartilage that is available to be harvested for other grafts in the surgery is essential.

An Innovative Treatment Using Calcium Hydroxyapatite for Non-Surgical Facial Rejuvenation: The Vectorial-Lift Technique

BackgroundThe facial aging process entails alterations in the volume, shape, and texture of all skin layers over time. Calcium hydroxyapatite (CaHA) is a well-established safe skin filler with unique properties to resolve some skin alterations by stimulating neocollagenesis. The vectoral-lift (V-lift) technique targets the global repositioning of facial structures by addressing distinct anatomical injection planes. It includes deep facial augmentation with Radiesse PlusTM to retain ligament restructuring and superficial subcutaneous enhancement with diluted Radiesse DuoTM. Herein, we present cases that illustrate the use of this approach.MethodsThis pilot study enrolled 36 participants (33 women and three men; ages 37–68 years) in a Brazilian clinical setting, and all patients underwent a single treatment. Photographs were taken at rest, in frontal and oblique views, before injection, and 90 days after treatment.ResultsTreatment resulted in elevation of the upper and middle face, notable improvements in the infraorbital hollow, and adjustment of the mean facial volume.ConclusionsThe V-lift technique is a three-dimensional pan-facial treatment that relies on ligament support and face vectoring to obtain a lifting effect and facial contour restoration. It encompasses deep facial augmentation involving the use of Radiesse PlusTM for restructuring and retaining ligaments and Radiesse DuoTM for superficial subcutaneous enhancement. This approach targets a global repositioning of the facial structures by addressing distinct anatomical injection planes. It achieves a repositioning of the overall facial anatomy without requiring a substantial volumetric expansion.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Facial Painting and 3D Stereophotogrammetric Analysis of Facial Dynamics: A Reliable Anatomical Educational Method.

(1) Background: Accurate knowledge of the dynamic anatomy of facial muscles is crucial for the use of functional and aesthetic botulinum toxin injections. We studied the reliability and relevance of facial painting as a pedagogic tool for the dynamic anatomy of facial muscles. (2) Methods: Different facial expressions were performed by a female model after a professional makeup artist applied makeup to the various facial muscles on her left hemiface. A 3D photograph was taken at the beginning and end of each movement using the VECTRA H2 Imaging System device. Cutaneous movements were visualized using displacement vectors. The correlation between the theoretical and dynamic positions of the makeup-muscle was assessed by two facial anatomy experts, thanks to a correlation scale. (3) Results: The overall average score for the 11 analyzed muscles or muscle groups was 3.36 out of 4, indicating a "strong" to "very strong" estimated correlation. There was a moderate agreement between Evaluator 1 and Evaluator 2 (ICC: 0.64; 95%CI: [0.244; 0.852]; p-value: 0.005). (4) Conclusions: The educational model with facial makeup provides an indirect but nonetheless precise and reliable representation of all facial muscles on the skin's surface. It is presented as a reliable and reproducible method, which exhibits great potential as a teaching tool.

Hampshire Sheep as a Large-Animal Model for Cochlear Implantation.

Sheep have been proposed as a large-animal model for studying cochlear implantation. However, prior sheep studies report that the facial nerve (FN) obscures the round window membrane (RWM), requiring FN sacrifice or a retrofacial opening to access the middle-ear cavity posterior to the FN for cochlear implantation. We investigated surgical access to the RWM in Hampshire sheep compared to Suffolk-Dorset sheep and the feasibility of Hampshire sheep for cochlear implantation via a facial recess approach. Sixteen temporal bones from cadaveric sheep heads (ten Hampshire and six Suffolk-Dorset) were dissected to gain surgical access to the RWM via an extended facial recess approach. RWM visibility was graded using St. Thomas' Hospital (STH) classification. Cochlear implant (CI) electrode array insertion was performed in two Hampshire specimens. Micro-CT scans were obtained for each temporal bone, with confirmation of appropriate electrode array placement and segmentation of the inner ear structures. Visibility of the RWM on average was 83% in Hampshire specimens and 59% in Suffolk-Dorset specimens (p = 0.0262). Hampshire RWM visibility was Type I (100% visibility) for three specimens and Type IIa (> 50% visibility) for seven specimens. Suffolk-Dorset RWM visibility was Type IIa for four specimens and Type IIb (< 50% visibility) for two specimens. FN appeared to course more anterolaterally in Suffolk-Dorset specimens. Micro-CT confirmed appropriate CI electrode array placement in the scala tympani without apparent basilar membrane rupture. Hampshire sheep appear to be a suitable large-animal model for CI electrode insertion via an extended facial recess approach without sacrificing the FN. In this small sample, Hampshire specimens had improved RWM visibility compared to Suffolk-Dorset. Thus, Hampshire sheep may be superior to other breeds for ease of cochlear implantation, with FN and facial recess anatomy more similar to humans.

Cleft lip and palate surgery simulator: Open source simulation model

ObjectiveCleft lip and palate is the most common craniofacial birth anomaly and requires surgery in the first year of life. However, craniofacial surgery training opportunities are limited. The aim of this study was to present and evaluate an open-source cleft lip and palate hybrid (casting and three-dimensional (3D) printing) simulation model which can be replicated at low cost to facilitate the teaching and training of cleft surgery anatomy and techniques. DesignThe soft tissue component of the cleft surgery training model was casted using a 3D printed 5-component mold and silicone. The bony structure was designed to simulate the facial anatomy and to hold the silicone soft tissue. SettingTwo groups, one group of trainees and one group of expert surgeons, at University Hospital Basel in Switzerland and Pontifical Catholic University of Chile in Santiago, Chile, tested the cleft lip and palate simulation model. Participants completed a Likert-based face and content validity questionnaire to assess the realism of the model and its usefulness in surgical training. ResultsMore than 70 % of the participants agreed that the model accurately simulated human tissues found in patients with unilateral cleft lip and palate. Over 60 % of the participants also agreed that the model realistically replicated surgical procedures. In addition, 80–90 % of the participants found the model to be a useful and appropriate tool for teaching the anatomy and surgical techniques involved in performing unilateral cleft lip and palate repair. ConclusionThis open-source protocol provides a cost-effective solution for surgeons to introduce the cleft morphology and surgical techniques to trainees on a regular basis. It addresses the current financial barrier that limits access to commercially available models during the early stages of surgeon training prior to specialization in the field.

Why Do Nasolabial Folds Appear? Exploring the Anatomical Perspectives and the Role of Thread-Based Interventions.

The classification of nasolabial folds into three types, each with distinct causative factors and mechanisms, is explored. Age-related changes in facial skin and connective tissues are examined in detail, revealing variations across different facial regions due to variances in tissue firmness and thickness. The innovative 'Reverse Technique,' involving cog threads to enhance tissue traction and effectiveness in thread-lifting procedures, is introduced. Detailed technical guidelines, anatomical considerations, and safety measures are provided, emphasizing the importance of identifying optimal vectors and fixing points to achieve maximum lifting effects while minimizing potential risks, particularly those associated with vascular structures. Additionally, the 'Cross Technique using volumizing thread' is discussed, designed to smooth tissue boundaries and rejuvenate sagging areas. Facial anatomy, including the positioning of arteries and ligaments, is underscored as essential for ensuring the safety and efficacy of procedures. In conclusion, this review stands as a comprehensive guide for practitioners, offering insights into innovative thread-lifting methods and their applications in addressing nasolabial folds. The primary focus is on achieving optimal aesthetic results while prioritizing patient safety.

Automated Detection of Cat Facial Landmarks

The field of animal affective computing is rapidly emerging, and analysis of facial expressions is a crucial aspect. One of the most significant challenges that researchers in the field currently face is the scarcity of high-quality, comprehensive datasets that allow the development of models for facial expressions analysis. One of the possible approaches is the utilisation of facial landmarks, which has been shown for humans and animals. In this paper we present a novel dataset of cat facial images annotated with bounding boxes and 48 facial landmarks grounded in cat facial anatomy. We also introduce a landmark detection convolution neural network-based model which uses a magnifying ensemble method. Our model shows excellent performance on cat faces and is generalizable to human and other animals facial landmark detection.

SMAS repositioning technique utilizing cog thread: Anatomical perspectives.

Face-lifting surgeries were once common among individuals over 60 years old due to skin laxity, but recent trends favor thread lifting in this age group. Understanding dynamic changes in facial anatomy during postural shifts is essential. Fresh cadaver studies have demonstrated the passage of threads through the superficial musculoaponeurotic system (SMAS) layer, confirming the efficacy of the technique. Proper insertion depth targeting SMAS repositioning, rather than superficial skin layers, is crucial. The natural movement of tissues secured by thread (N-Cog and N-Fix, N-Finders Inc., Korea) insertion results in lifting effects. However, complications may arise if threads affect deeper facial muscles, leading to discomfort. Fibrous septa play a significant role in guiding thread placement, with different densities influencing thread maneuverability and tissue response during lifting. Procedures targeting SMAS repositioning using threads aim to maintain the new position of relocated tissues. Understanding structural variations in facial regions informs thread selection and placement. Aligning threads with tissue movement and the intended SMAS layer positioning is vital to prevent complications. Balancing thread insertion depth and tissue traction is critical for successful outcomes. Modern thread lifting techniques prioritize SMAS repositioning, enhancing lifting effects while ensuring procedure safety and efficacy.

Optimized Aesthetic Outcomes When Treating Glabellar Lines with Botulinum Toxin Type A: GLO 3 + 2: A Precise Technique Based on Anatomy.

Good patient outcomes after treatment of the glabellar complex with botulinum toxin type A entail elimination of glabellar lines and maintenance of a natural eyebrow position. A precise injection technique that accurately targets the muscles that influence eyebrow position is required to reduce the risk of adverse aesthetic outcomes or unmasking an underlying eyelid ptosis. Here, we describe the glabellar lines optimization (GLO 3 + 2) injection anatomy technique, a precise five-point injection pattern that is based on current understanding of facial functional anatomy and which aims to minimize the risk of affecting nontargeted muscles. Injection sites above the brow or that do not target the precise location of the muscles in the glabellar complex are likely to inadvertently expose the frontalis to botulinum toxin type A and result in undesirable aesthetic outcomes. Because the frontalis is a strong determinant of aesthetic outcomes, it is important to consider the overall effects of the interactions between the eyebrow depressors and the opposing forces of the frontalis on brow outcomes in both the resting brow position and during dynamic brow movement.

Investigating the Contraction Pattern of the Zygomaticus Major Muscle and its Clinical Relevance: A Functional MRI Study.

Our understanding of facial anatomy has significantly evolved, yet the detailed contraction patterns of facial muscles and their presentation during clinical imaging remain largely unexplored. Understanding the contraction patterns and visual presentation of these muscles, particularly the zygomaticus major could enhance pre-surgical facial assessments and the development of new treatment strategies. A total of 34 healthy young individuals (17 female, 17 male) with a mean age of 23.6 (2.4) years [range: 20-30] were investigated regarding the length, thickness, width, and angle of the zygomaticus major muscle in five different facial expressions (i.e., repose, anger, joy, surprise, and sadness) utilizing MR imaging. Joyful expressions caused a reduction in muscle length to 85.6% of its original length and anincrease in width (103.4%), thickness (108.4%), and facial angle (2.72°) when compared to that in repose, suggesting isotonic contraction. Conversely, expressions of anger, surprise, and sadness generally led to muscle stretching, seen through changes in length (98.9%, 104.3%, and 102.7%, respectively), width (98.8%, 96.5%, and 99.4%, respectively), and thickness (91.2%, 91.0%, and 102.7%, respectively), with variable alterations in facial angle (0.55°, 1.85°, and 1.00°, respectively) depending on the specific expression. This MRI-based study indicates that the zygomaticus major muscle experiences isotonic contraction, characterized by decreased length and increased width and thickness. The findings underline the importance of muscle thickness as a reliable parameter in assessing facial muscle function and offer valuable guidance for practitioners in accurately evaluating muscle performance during different facial expressions. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Exploring facial overfilled syndrome from the perspective of anatomy and the mismatched delivery of fillers.

Facial fillers and injectables have transformed the landscape of cosmetic procedures, offering rejuvenation possibilities. However, the emergence of "Facial Overfilled Syndrome (FOS)" presents a concerning trend attributed to excessive filler use and suboptimal injection techniques. Understanding the interplay between facial aging and augmentation techniques is crucial in addressing and preventing FOS. Facial overfilled syndrome is characterized by the excessive use of fillers, resulting in a distorted and heavy appearance. It manifests in various forms, including 'flowerhorn' foreheads, 'sunset' eyes, 'chipmunk' cheeks, 'witch' chins, and 'pillow' faces. The syndrome arises from attempts to combat anatomical aging with dramatic filler treatments, causing rapid volume changes and skin tightening. Skeletal structures and soft tissue distribution across different ethnicities play a significant role in FOS development. Understanding the aging process across facial tissues is essential, as fillers cannot entirely reverse aging manifestations. Tailored assessment and treatment plans should precede filler injections, involving muscle assessment, observation of facial movements during injection, and ultrasound imaging of fat layers. Attention should be given to filler pressure and migration risks, particularly in areas with elevated pressure. Additionally, alternative approaches like energy-based devices and polymer reinforcement of facial ligaments should be considered to minimize filler use. Ethnic variations in facial anatomy require careful consideration to avoid overcorrection. FOS predominantly affects individuals of East Asian descent due to specific facial characteristics. Prevention strategies involve minimizing filler use, addressing underlying bone changes, and considering ethnic and gender differences in facial anatomy. Recent MRI and ultrasound studies challenge the notion of filler breakdown, emphasizing the importance of filler selection and injection techniques. Education, individualized treatments, and a holistic understanding of facial anatomy are key to preventing and managing FOS and ensuring natural and harmonious facial aesthetics.

U-SMAS: ultrasound findings of the superficial musculoaponeurotic system.

The superficial musculoaponeurotic system (SMAS) is a complex fibrous network connecting facial muscles to the dermis, with varying morphological characteristics across different facial regions. Recent studies have identified five distinct types of SMAS morphology, highlighting the need for region-specific interventions in facial rejuvenation. This pictorial essay explores ultrasound imaging of the SMAS using ultra-high frequency (24-33 MHz) probes, known as U-SMAS. Analysis of 186 full-face U-SMAS scans revealed consistent patterns in the facial and neck layers, with regional variations aligning with the Sandulescu classifications: type I (preparotideal); type II (chin and lip); type III (eyelid); type IV (temporal and parotideal); and type V (cervical). Understanding these morphological differences is crucial for accurate interpretation of ultrasound images and for optimizing pre-procedural assessments to ensure that aesthetic treatments are safe and effective. Knowledge of the SMAS architecture enhances the ability to visualize facial and neck anatomy accurately, particularly through U-SMAS imaging, ensuring comprehensive patient care in rejuvenation procedures.

Facial Nerve Considerations for the Deep Plane Facelift and Neck Lift.

The surgical approach to facial rejuvenation has evolved significantly over the last century. As surgeons have deepened their understanding of facial anatomy over the last half century, so have their surgical approaches to the rhytidectomy, with increasingly extensive manipulation of the underlying soft tissue in the face. While these procedures have become more comprehensive and natural in their approach, the risk of temporary facial palsy also appears to be on the rise. In this text, we review the technique for deep plane facelifts and neck contouring with an emphasis on the facial nerve anatomy and methods to preserve the intricate facial nerve network during tissue dissection and modification. Careful execution of the surgical steps involved, including deep neck contouring, SMAS (superficial musculoaponeurotic system) suspension, and skin management, is essential to achieve the authentic aesthetic outcomes that patients desire while ensuring patient safety.

Complications Associated with Facial Autologous Fat Grafting for Aesthetic Purposes: A Systematic Review of the Literature.

With the increasing demand for aesthetic procedures, autologous fat grafting (AFG) seems to be an attractive option for facial volumization and rejuvenation. The aim of this study was to assess the type and severity of associated complications after facial AFG for aesthetic purposes. The entire PubMed/Medline and Cochrane databases were screened to identify studies describing complications that occurred after the injection of autologous fat into the face. These complications have been reviewed and analyzed according to their occurrence and severity in the different anatomical regions of the face. Twenty-two articles including 38 patients reported on a total of 58 complications. Thirty-two complications have been classified as severe or permanent, including hemiplegia (n = 11), loss of vision (n = 7), or skin necrosis (n = 3). The other 26 complications were classified as mild or transient, such as lipogranuloma (n = 12) or mycobacterial abscess (n = 2). The majority of complications were reported after injection to the forehead (n = 26) and the temporal region (n = 21). Interestingly, this location seems to be the area at risk because 53% of all severe complications occurred in this anatomical region. AFG to the face is associated with a low incidence of complications, but if they occur, they can be dramatic, particularly in the forehead and temporal region. Nevertheless, AFG can be used to correct age-related changes of the face and volume loss and may represent an alternative to synthetic fillers. Therefore, AFG to the face should be performed by qualified doctors under careful consideration of risks and facial anatomy.

Неврологические осложнения в косметологии: обзор литературы

INTRODUCTION. The article discusses complications from the nervous system during such cosmetic procedures as botulinum therapy, the use of fillers, mesotherapy and thread lifting. AIM. Conduct an analysis of literary sources of domestic and foreign authors describing the modern understanding of neurological complications that arise in cosmetology practice. MATERIAL AND METHODS. An analysis of literature in Russian and English was carried out for the period from 2013–2024. Sources from the Russian scientific electronic library eLIBRARY, RSCI databases, and PubMed were used. RESULTS AND DISCUSSION. One of the most common neurological side effects of botulinum toxin is paralysis of the facial and masticatory muscles, innervated by the facial and trigeminal nerves, respectively. The mechanism of the negative effect of fillers on nervous tissue is associated, first of all, with their composition, which can have a toxic effect. During filler injections, nerve fibers can be damaged, which leads to disruption of the transmission of nerve impulses. The literature describes cases of deterioration or even loss of monocular vision, ptosis and ophthalmoplegia after injection of hyaluronic acid filler. A complication when using fillers based on hyaluronic acid and autologous fat is acute cerebrovascular accident. Prevention of neurological complications during cosmetic procedures is an important aspect of safety and successful results in aesthetic medicine.CONCLUSION. Neurological complications can occur as a result of various cosmetic procedures. The main factors are technique, lack of understanding of facial anatomy, and the use of low-quality drugs. It is important to be aware of the potential risks and contact only experienced specialists to reduce the likelihood of neurological complications. KEYWORDS: fillers, botulinum therapy, thread lifting, neurological complications, facial nerve neuropathy

A rare case of a large tumour located under the facial nerve trunk

Aim: to introduce a technique of total parotidectomy sparing the facial nerve branches based on a clinical case. The article presents a clinical case of a large parotid tumour located under the facial nerve trunk, the stages of its surgical removal, and the postoperative course. Parotidectomy is one of the most complicated operations in maxillofacial surgery. When performing this surgical intervention, a surgeon must observe the principles of ablastics, consider individual peculiarities of the facial nerve anatomy structure and relations of nerve and tumour, and be ready to expand the scope of the operation from subtotal to total parotidectomy. Conclusions. To improve the treatment outcomes of patients with benign parotid tumours and to reduce the number of such postoperative complications as paresis and paralysis of the mimetic muscles caused by facial nerve injury, one should know and follow the technique of parotidectomy, especially in the case of a neoplasm located under the trunk or branches of facial nerve. The research was adhered to the principles of the Declaration of Helsinki. The patient informed consent was obtained for the study. No conflict of interests was declared by the authors.