Article title:
Facial Reanimation with Labbe Myoplasty Followed by Complex Rehabilitation
Authors:
A.A. Fedortsov , I.P. Moshurov , B.V. Petrov , O.V. Manukovskaya
For citation:
Fedortsov AA, Moshurov IP, Petrov BV, Manukovskaya OV. Facial reanimation with labbe myoplasty followed by complex rehabilitation. Otorhinolaryngology, Head and Neck Pathology (ORLHNP). 2024; 3 (1): 69–72.
Abstract:
Introduction: the tumor’s presence in the parotid salivary gland can lead to the development of facial paralysis in 1.67% of cases, and parotidectomy for neoplasms of this localization is complicated by iatrogenic damage to the facial nerve in 6-29.6%. Neurological insufficiency of the facial nerve leads to poor health state, both physical and mental. The facial resuscitation which includes a complex of therapeutic and surgical, together with rehabilitation measures, reduce these complications and improve the general condition of the patient. Lengthening temporalis myoplasty according to Labbé is recommended for use in facial nerve paralysis of various etiologies, including posttraumatic (iatrogenic) paralysis. This article describes the first case of facial reanimation by Labbe temporal lengthening myoplasty performed in the department of head and neck tumors of Voronezh Regional Clinical Oncological Dispensary with subsequent complex rehabilitation.
Case: patient Ch., 52 years old (WAS born. in 1972), was diagnosed with: Cancer of the right parotid salivary gland, stage II T2N0M0, after combined treatment. Histologic diagnosis: adenocystic carcinoma. In 2021, the patient underwent combined treatment, the surgical component of which included parotidectomy with fascial-futlar excision of the neck fiber. The paralysis of the facial muscles appeared after the operation.
After two years, the patient turned to the specialists of the head and neck tumor department of VRCOD with complaints of lacrimation from the right eye, its dryness and salivation on the right side. It was decided to perform myoplasty by lengthening the temporal muscle. After 3 months of complex rehabilitation, patient C. has complete eyelid closure on the affected side of the face, almost complete symmetry of the corners of the mouth, absence of lacrimation, salivation and «sail symptom» on the right side. She has already mastered the temporomandibular smile and has begun to learn the voluntary temporal smile. Rehabilitation continues as planned.
Conclusively: the first precedent of Labbe myoplastyapplication in the department of head and neck tumors of Voronezh Regional Clinical Oncologic Dispensarywith subsequent complex rehabilitation can be considered successful. The further use of this technique will be advisable with the possibility of gradual introduction into practice more methods of surgical facial resuscitation and improvement of the developed rehabilitation tactics.
Keywords:
clinical case, oncology, facial resuscitation, complex rehabilitation