Title Suvremeni koncept reanimacije lica
Title (english) Contemporary Concept of Facial Reanimation
Author Patricija Belužić
Mentor Alan Pegan (mentor)
Committee member Marko Velimir Grgić (predsjednik povjerenstva)
Committee member Mihael Ries (član povjerenstva)
Committee member Alan Pegan (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Othorhinolaryngology and Head and Neck Surgery) Zagreb
Defense date and country 2024-07-12, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Otorhinolaryngology
Abstract Lični živac zaslužan je za inervaciju mimičnih mišića glave i vrata čijom se kontrakcijom oblikuju različiti izrazi čovjekovog lica. Lični živac može biti oštećen čimbenicima poput traume, infekcije ili tumora, no nerijetko uzrok njegove disfunkcije ostaje nepoznat. Kod pacijenata s parezom/paralizom ličnog živca vidljiva je mlohavost jedne polovice lica. Mogu biti prisutne poteškoće prilikom pijenja, jedenja i artikulacije govora. Nadalje, pacijenti ne mogu mimikom iskazati svoje emocije,
... More pogotovo sreću oblikovanjem osmijeha, što značajno otežava komunikaciju između pacijenta i okoline. Osim funkcionalnih posljedica, za pacijente je značajan i estetski manjak koji se manifestira gubitkom simetrije i ravnoteže na licu. Na početku kliničke obrade pacijenta važno je definirati vrijeme nastupa kljenuti, kao i potencijalne uzroke i čimbenike rizika. Za određivanje stupnja paralize koriste se House-Brackmann i Sunnybrook ocjenske ljestvice. Liječenje je u prvom redu etiološko, no ono često nije moguće ili nije u potpunosti uspješno. Terapijske metode tada podrazumijevaju vraćanje ravnoteže, simetrije i pokreta u paralizirano lice kirurškim putem, što se naziva reanimacijom lica. Reanimacija lica obuhvaća statičke i dinamičke kirurške metode. Danas prednost imaju dinamičke metode i uključuju izravni popravak živca, primjenu interpozicijskih presadaka, transfer lokalnih motoričkih živaca, CFNG i lokalne i slobodne mišićne režnjeve. Uz kirurško liječenje, ili kao njegova zamjena, mogu se primjenjivati poštednije metode poput kemodenervacije botulinum toksinom i fizikalne terapije i rehabilitacije. Prilikom odabira metode liječenja ključno je definirati koliko je vremena proteklo od nastupa kljenuti. Ako je prošlo manje od godinu dana, primjenjuju se reinervacijske metode poput izravnog popravka živca, interpozicijskih presadaka i CFNG. Ako je prošlo više od godinu dana, denervirani mimični mišići gube sposobnost reagiranja na živčane impulse i ireverzibilno atrofiraju. Tada se primjenjuju lokalni i slobodni mišićni režnjevi kako bi nadomjestili funkciju atrofiranih mimičnih mišića zahvaćene polovice lica. Less
Abstract (english) The facial nerve is responsible for innervating the mimetic muscles of the head and neck, whose contractions form various facial expressions. The facial nerve can be damaged by factors such as trauma, infection, or tumors, but often the cause of its dysfunction remains unknown. Patients with facial nerve paresis/paralysis exhibit flaccidity on one side of the face. They may have difficulties drinking, eating, and articulating speech. Additionally, they cannot express their emotions
... More through facial expressions, especially joy through forming a smile, which significantly impairs communication between the patient and their surroundings. Besides functional consequences, patients also face significant aesthetic deficiencies manifested by the loss of facial symmetry and balance. At the beginning of the clinical assessment, it is important to determine the onset of the paralysis, as well as potential causes and risk factors. The degree of paralysis is assessed using the House-Brackmann and Sunnybrook grading scales. Treatment is primarily etiological, but this is often not possible or completely successful. In those cases, therapeutic methods aim to restore balance, symmetry, and movement to the paralyzed face surgically, which is known as facial reanimation. Facial reanimation includes both static and dynamic surgical methods. Today, dynamic methods are preferred and include direct nerve repair, the use of interpositional grafts, transfer of local motor nerves, CFNG, and local and free muscle flaps. In addition to surgical treatment, or as an alternative to it, more conservative methods such as chemodenervation with botulinum toxin or physical therapy and rehabilitation can be applied. When choosing a treatment method, it is crucial to define how much time has passed since the onset of the paralysis. If less than a year has passed, reinnervation methods such as direct nerve repair, interpositional grafts, and CFNG can be used. If more than a year has passed, the denervated mimetic muscles lose their ability to respond to nerve impulses and irreversibly atrophy. In such cases, local and free muscle flaps are used to replace the function of the atrophied mimetic muscles of the affected side of the face Less
Keywords
kljenut ličnog živca
reanimacija lica
popravak živca
CFNG
slobodni režnjevi
Keywords (english)
facial nerve palsy
facial reanimation
nerve repair
CFNG
free flaps
Language croatian
URN:NBN urn:nbn:hr:105:005477
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-06-26 09:28:02