Microsurgery in Facial Paralysis
Repair with Microsurgical Techniques in Facial Paralysis; Facial paralysis is a very common facial deformity that results from paralysis of the facial nerve (Facial nerve) that causes both aesthetic and functional problems.
Repair with Microsurgery Techniques in Facial Paralysis
Facial paralysis is a fairly common facial deformity resulting from paralysis of the facial nerve (Facial nerve) that causes both aesthetic and functional problems.
The most common cause is sudden cold competition or sudden facial paralysis of unknown cause (Bell’s palsy). These patients improve completely with the appropriate drug treatment at a rate of 80%. However, the first 3 weeks is a very critical period. This period should be spent under medical supervision. Because, if the smoothing period is not entered during the 3-week period and if there is no positive development in the paralyzed muscles, the channel in the temporal bone, where the border enters the face, should be urgently loosened. Otherwise, the possibility of developing permanent facial paralysis in the individual is very high.
The most common causes of chronic facial palsy are congenital facial palsy, after surgery of the cerebellum and adjacent tumors called corner tumors, and trauma.
Therefore, according to my clinical opinion, how to treat facial paralysis is as follows.
If you have sudden facial paralysis
- steroid therapy
- anti-inflammatory drug
- Application of heat and protection from cold
As I said here before, the critical deadline is 3 weeks. If there is no positive development in the paralysis during this period, the channel through which the facial nerve travels in the bone, called decompression, should be loosened immediately.
Facial paralysis could not be detected by the doctor in the first acute period, but cases newer than 6 months
If each muscle does not receive an electrical impulse by a self-stimulating border for approximately 6 months due to border damage, permanent damage occurs to this muscle. Even if the border is repaired after this period, this muscle has no chance of working. For this reason, in order for my patients to be able to save the muscles during this time, I am trying to save these muscles and make them work in their usual way by stitching the language border or a border that works the neck muscles with a technique called English baby sitter. This technique, in my opinion, is the most appropriate surgical procedure to give those muscles a chance to recover.
Late period facial paralysis over 6 months-1 year;
Here now the muscles are irreversibly damaged. Therefore, a muscle transplant is needed to replace facial muscles. Although there are many methods, I will tell you about my choice.
While many methods require a two-stage surgery, the method I chose is a single-stage surgical procedure. While I had previously chosen the two-stage method, now I choose the single-stage method due to some disadvantages of these methods. In the surgical procedure I chose, the muscle (grasillis muscle) taken from the inner side of the leg is thinned and placed on the sides of the face and nose. However, before this process, I thin the muscle a lot for an aesthetic result. Then I stitch the border of the muscle to the chewing muscle border. According to my clinical experience, which has also been reported in recent scientific publications, this limit works the muscle I transplanted quite strongly. When successful at the end of approximately 6-8 months, this transplanted muscle adapts to the face enough to enable normal laughing, speaking and being in social environments without attracting attention.
Removing the Grasillis Muscle and Moving it to the Face
Even if the person laughs by thinking about the chewing movement at the beginning, the brain can learn this process quite appropriately over time, and the person can smile spontaneously in the future. Especially in children, this development is at a very high level.
In addition, patients with facial paralysis also have difficulties in closing their eyes. The two methods I frequently use are the static method of placing a gold plate on the upper eyelid and ensuring its closure by obtaining scales, and the dynamic method of turning the temporal chewing muscle to the upper and lower eyelids by voluntarily taking it and closing the eye.