New Treatment of Facial Paralysis by

Microsurgery with NTL (Viterbo Technique)

Facial paralysis is a disfiguring disorder with significant psychological impact, emotional and family, leading to these suicidal patients, because these patients are marginalized in their families, work and their social environment ...





Surgery corrects facial paralysis
Published by the Trade Journal (May 28, 2011)







Surgery corrects facial paralysis

For 12 years, Jose Luis Altamirano suffered facial paralysis. The first symptoms appeared while the painter was in an exhibition of his works. Suddenly found he could not blink on one side. And soon the condition is spread throughout the right side of his face.

Since then he went to several consultations, followed by multiple treatments and even investigated the possibility of an operation to cure his disease. But found no results.

In 1971, the United States, France, Taiwan and Japan have developed several corrective microsurgery techniques. But the consequences were not cleared at all. Six years later, in Brazil, several surgeons modified their techniques. Until Dr. Fausto Viterbo, University of Botucatu, Sao Paulo, devised the technique Viterbo.

The Ecuadorian surgeon Walter Huaraca Francisco specializing in this procedure. The surgery involves removing a tissue called the lateral thigh fascia lata. After the sural nerve is removed from the back of the leg, which is approximately between 35 and 40 inches long.


Points out that these extractions Huaraca pose no risk to the patient.

That nerve is used on the face, as a graft under the microsurgical technique. Using microscopes and magnifying glasses microsurgical suture is made between the healthy facial nerve and the other end of the nerve implant, which is inserted into the temporalis muscle.

In this way achieves a direct mioneurotización, ie, the patient obtains a spontaneous and symmetric smile.

After the intervention, and physical therapy are to achieve coordinated facial movements in a mirror, the patient will smile spontaneously after six to eight months.
For its thoroughness, the operation can last from five to six hours when it comes to total paralysis and requires a team of six surgeons. Intervention is a minimal incision, so there are no scars.

This technique was first held in Guayaquil on Monday, the Dirección.

The specialist said that the degree of effectiveness of the procedure is 95%.

Jose Luis Altamirano was the first patient. Last Wednesday he attended a medical checkup and was able to see improvement. You can sketch a slight smile on his face and can close in its entirety, the right eyelid.

According to global studies, between 10 and 40 people per 100 000 inhabitants suffer from facial paralysis. The causes are multiple. They may be congenital, caused by genital herpes during pregnancy or poor medical maneuver at birth.

Ear infections can also affect the facial muscles and produce paralysis. Blows to the mandibular region, accidents or falls to the level of the neck are other causes, like herpes simplex. And the changes are discarded in temperature as a trigger for this condition.

For now, Huaraca has a list of 12 patients who are undergoing assessment for undergoing surgery. His first patient, Jose Luis Altamirano, enthusiastic and feels privileged to benefit. Hopes to launch physical therapy to recover as soon as possible and continue with their activities.

This condition is more common in women 10 to 20 years and men over 40 years.

Remember that the clinical picture has a sudden onset and progressive during the first 14 days, characterized by pain in front and / or behind the ear, decreased sensation in the middle of the face, inability to close the eyelids and corner of mouth drop .

10% of cases are bilateral paralysis. Between 60 and 80% of cases have a full recovery. While 7% is recurrent.

With surgery, the results obtained corresponding to 95% regression of facial movements.













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