Different types of surgical procedures onto facial nerve are related to its pathologic disorders as follows: facial nerve decompression within its bony pathway, external and interfascicular neurolysis, neurosuture at intratemporal or extratemporal part, neuroplasty with neurotransplant, neuroanastomosis with other cranial nerves or reconstructive surgical interventions.
The choice of method of surgical treatment depends on height of nerve lesion, time elapsed from injury, integrity of proximal and distal part of the nerve, quality of mimic muscles, age of the patient, associated degenerative and vascular diseases, as well as the patient’s desire.
In most of the patients physiatric treatment has been prolonged so far the atrophy of mimic muscles results. In such situations the reconstruction of paralyzed face can be performed with microvascular transfer of gracilis or minor pectoral muscle, as well as temporal or masseter muscle usage by method of Ruben.
Ruben method provides excellent results due to function of eyelids closure, while the suspension of orbicularis oris muscle in most cases requires later revision.
Much better results are obtained when specific physical rehabilitation is applied within the first 24 h after surgical procedure.
In relation to microvascular transfers, Ruben method has been favored at the Clinic for Maxillofacial Surgery of the MMA.
Conflict of interest: None declared.