[Nasolabial suspension of the malar fat pad: a new, minimally invasive and reversible technique for facial symmetrization in permanent facial paralysis].

Abstract:

:Introduction: For the treatment of asymmetry of the midface due to permanent peripheral facial nerve palsy of different etiologies - which means a great psychical burden for the patients - several surgical solutions have been described. Aim: Our goal was to elaborate a minimally invasive surgical technique, that, on one hand, restores an adequate nasolabial fold, which is the most determinative keystone of facial symmetry. On the other hand, our technique can give an appropriate lift for the malar fat pad with shorter operative time and burden, with much lower complication rate and shorter recovery period compared to the classic static sling suspension techniques. Method: Out method is based on the formation of a neo-nasolabial fold, which is then suspended to the temporal fascia by permanent threads thus restoring facial symmetry and giving a lifting effect on the midfacial soft tissues as well. Results: Between 2014 and 2017, six patients had been operated with this nasolabial lifting technique of the malar fat pad without any major complications under local anesthesia on an outpatient basis at our Department. Conclusions: As our surgical exploration is minimal, the postoperative period is shorter, no visible scars remain on the face and the complication rate is negligible. If necessary, suspension could easily be adjusted, and as the technique is reversible, no other possible facial reconstruction methods are excluded. Our method can symmetrize the face in resting position completely on the long term, which is the most important issue for our patients according to their feedback. Orv Hetil. 2019; 160(22): 869-872. :Absztrakt: Bevezetés: A különböző etiológiájú, végleges perifériás arcidegbénulás következtében kialakuló középarc-aszimmetria – mely a betegek számára jelentős pszichés megterhelést jelent – rekonstrukciójára számos sebészi lehetőség kínálkozik. Célkitűzés: Olyan minimálinvazív sebészi módszer kidolgozása volt a célunk, mellyel a nasolabialis redő – mint az arc szimmetriájának egyik legmeghatározóbb eleme – helyreállítása mellett a középarc lágy részeinek megfelelő statikus felfüggesztése érhető el kisebb műtéti megterheléssel, rövidebb műtéti idővel és lényegesen kevesebb szövődménnyel, valamint gyorsabb felépüléssel. Módszer: Technikánk alapja egy neo-nasolabialis redő képzése, melynek subcutan fonalpárokkal történő rögzítése a temporalis fasciához nem csupán az arc szimmetriáját állítja helyre, de a középarc lágy részeit is megemeli. Eredmények: Klinikánkon 2014 és 2017 között egynapos sebészet keretében 6 betegnél végeztük el a középarc lágy részeinek nasolabialis függesztését, érdemi szövődmény nélkül, helyi érzéstelenítésben. Következtetés: A műtéti feltárás minimális, így a posztoperatív szak jelentősen lerövidül, torzító hegekkel látható területen nem kell számolni, a sebgyógyulási zavar lehetősége minimális. Amennyiben szükséges, a felfüggesztés mértéke revideálható, és mivel reverzibilis, a függesztőfonalak bármikor eltávolíthatók, ily módon semmilyen egyéb arcideg-rekonstrukciós lehetőséget nem zárnak ki. Módszerünk képes az arc nyugalmi helyzetét tartósan és teljes mértékben szimmetrizálni, ami betegeink visszajelzése alapján a legfontosabb tényező számukra. Orv Hetil. 2019; 160(22): 869–872.

journal_name

Orv Hetil

journal_title

Orvosi hetilap

authors

Vass G,Bere Z,Szabó D,Rovó L

doi

10.1556/650.2019.31344

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

869-872

issue

22

eissn

0030-6002

issn

1788-6120

journal_volume

160

pub_type

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