Facial muscle paralysis is a pathological debilitating condition that is often associated with dramatic functional, psychological and cosmetic consequences of a negative nature. The consequences of facial nerve (FN) damage are a serious medical and social problem, as they have a devastating effect on a number of important aspects of human life (psychological, aesthetic, economic), which significantly reduces the quality of life of patients. The inability to fully express emotions creates an extremely strong imprint on the psychological state of patients, and facial asymmetry limits the comfortable stay in society and even leads to severe depressive disorders in this category of patients (Nellis JC, Ishii M, Byrne PJ et al., 2017; Chang YS, Choi JE, Kim SW et al., 2016; Goines JB, Ishii LE, Dey JK et al., 2016).
The facial nerve (FN) ranks first among other cranial nerves in the frequency of lesions (Kaverina VV, 1975; Nerobeev AI, 1997; Kalakutsky NV, Pakhomova NV, Petropavlovskaya OY, 2016). FN is responsible for facial expressions and expression of emotions, participates in ensuring the protective function of the eye, the formation of tear fluid, salivation, partially provides taste function and even participates in nasal breathing (Peypl AD, 2007).
When FN is damaged, there is a pronounced asymmetry of the face, which distorts the appearance, as a result of which the patient becomes the object of increased attention, which further negatively affects his psycho-emotional status. Also characteristic are impaired vision, speech, decreased muscle tone of the mouth and cheeks, which leads to problems with chewing, and there is difficulty in nasal breathing. Among the causes of FN neuropathy should be noted mechanical damage to the
FN or its trunks in traumatic brain and craniofacial trauma, as well as a wide range of iatrogenic injuries associated with the removal of tumors of the posterior cranial fossa (most often – acoustic neuromas), salivatory gland tumors also with surgical interventions in various diseases of the peripheral part of the auditory analyzer (Hohman MH, Hadlock TA, 2014; Spencer CR, Irving RM, 2016; Reich SG, 2017; Zhang W, Xu L, Luo T et al., 2019; Teresa MO, 2018).
Despite the rapid development of nerve microsurgery, the availability of modern diagnostic tools and methods of treatment of patients with FN trauma, the problem of full recovery of its function remains unresolved. There is no so-called "gold standard" for surgical treatment of FN injuries, as there are many techniques that differ significantly in their concept, and each of them has its supporters.
Our work highlights the results of surgical treatment of a large number of patients with LN injuries compared to the work of reputable specialists (Volk GF et al., 2020; Socolovsky M et al., 2016; Biglioli F et al., 2016; Biglioli F et al., 2017; Vila PM et al., 2020; Gao Z et al., 2019 etc) over the past 5 years, which presents a small number of patients in whom various methods of LN reinnervation were used.
This dissertation research is devoted to the study of of surgical treatment results of the FN injuries consequences by different surgical methods of treatment. This will allow on the basis of a large number of observations (202 patients) to choose the most effective method of FN reinnervation with the achievement of optimal functional and aesthetic results. Among the biomedical problems associated with FN palsy, the choice of an effective type of facial nerve transfer is relevant. This study is devoted to solving this issue.
The aim of the study: increasing the efficiency of restoring the structure and function of the facial nerve in patients with its injuries of different genesis, which is to optimize a set of therapeutic and diagnostic measures, determine the most appropriate surgical treatment type of facial nerve in the treatment of its trauma, aimed at maximum recovery of lost nerve function.
