The surgery opened up the opportunity to regain a smile and confidence for Ms. D. T. X. T (44 years old, Hai Phong), who had lived with a crooked face for more than 40 years.
According to medical records, Ms. T was paralyzed on the left side of her face from about the age of 2 after a long illness. Since then, the facial muscles on the left side have almost completely lost their ability to move, making the face increasingly uneven. When smiling, talking or expressing emotions, only one facial muscle is active, so the face is always unbalanced. This situation has lasted throughout childhood and even when she grew up, greatly affecting her psychology and life.
At the age of 25, she underwent initial surgery to place a trans facial nerve - a technique to transmit nerve signals from the healthy side of the face to the paralyzed side to create a foundation for later motor recovery. According to the treatment plan, after about 6 months, the patient will continue the muscle transplant phase to complete the recovery process.
However, due to psychological fear of pain and fear of surgery, Ms. T did not return for re-examination. Many years later, her face became increasingly sagging, especially on the paralyzed side, making her lack confidence when communicating. After 20 years, she decided to return to the hospital with the hope of improving facial balance.
At Hospital E, the patient was comprehensively assessed for nerve function and facial muscle structure. The results showed that she had prolonged left VII nerve paralysis for many years. This is the nerve that controls facial muscle movements such as laughing, speaking, frowning, or blinking. When this nerve is damaged, facial muscles lose their ability to contract, leading to crooked mouth, face tilt, or loss of expression.
For cases of facial paralysis lasting many years, facial muscles have often atrophied or lost function, making recovery more complicated.
After consultation, doctors decided to perform surgery to transfer the free slender muscle combined with nerve connection to regenerate facial muscle movement. The special feature of the surgery is that the grafted muscle is connected to two different nerve sources.
The first source is the bitten muscle nerve located near the injured area, which helps the grafted muscle receive signals early and begin muscle contraction after surgery. The second source is the trans facial nerve from the healthy side - the nerve that was placed from the previous surgery 20 years ago. This source helps synchronize movement on both sides of the face, creating conditions for patients to smile more naturally.
A slender muscle is a long, thin muscle located in the inner thigh, often used in reconstructive surgery because of its structural compatibility and the removal of part of this muscle does not significantly affect the movement of the legs.
In the surgery, a part of the slender muscle along with blood vessels and nerves feeding the muscle was removed from the thigh and transferred to the paralyzed face area. Under the surgical microscope, doctors performed blood vessel reconnection to nourish the muscle and nerve reconnection to transmit motor signals.
According to doctors, surgery is just the beginning. After surgery, patients need to be closely monitored and practice functional rehabilitation for a long time so that new muscles adapt to facial activity.
Experts also say that facial paralysis can be caused by many causes such as viral infection, trauma, tumors in the head - face - neck area or blood vessel disorders that nourish the VII nerve. When the nerve is deficient in blood supply and swollen in a narrow bone canal, nerve signals will be interrupted, causing facial muscles to be paralyzed.
