Resumo

Objectives: The purpose of this presentation is to demonstrated the possibility of symptomatic treatment in patients with facial hemiplegia using a combination of minimally invasive methods that allow to achieve an aesthetic effect resulting not only in the achievement of facial symmetry but also improvement in quality of life due to enhancement of the chewing function, speech and eyelid closure. Introduction: Facial asymmetry is a common problem encountered in the clinical practice of neurologists and surgeons. It can be congenital, post-traumatic or a consequence of various diseases, which lead to facial nerve palsy. The consequences are functional and aesthetic but also psychological disorders related to the patient's impaired communication with the environment, which increases depression and lowers self-esteem. In the presentation, the author's own experience of treating facial asymmetry in more than 90 patients with permanent peripheral facial nerve palsy is presented. Materials / method: All procedures were performed by the author of the presentation on patients with facial asymmetry after permanent facial nerve palsy caused by disease or trauma. Used methods: implantation of soluble P(LA/CL) and permanent lifting threads (polypropylene) for soft tissue lift on the paralyzed side in combination with botulinum toxin treatment (to correct hyperkinesia on the healthy side) and lipofiling in patients with lipodystrophy and tissue flaccidity. Results: The result of the applied treatment is the achievement of facial symmetry followed by improvement of chewing, speech and eyelid closure functions. Conclusion: The experience of the author of this presentation shows the high effectiveness of using P(LA/CL) threads as a method of minimally invasive facial symmetrization in facial nerve palsy. Through their use, both aesthetic and functional aspects can be affected, significantly improving the patient's quality of life. In order to achieve satisfactory treatment results, the most important thing is the individual approach to the patient and the ability to combine techniques using lifting threads with other therapeutic options : lipotransfer , botulinum toxin injections or / and hyaluronic acid.