Ritidoplastia em face espástica: relato de caso / Rhytidoplasty in patient with hemifacial spasm: case report

O espasmo hemifacial (EH) é um distúrbio do movimento caracterizado por contrações involuntárias dos músculos inervados pelo nervo facial, a descompressão microvascular(DMV) é considerada tratamento definitivo, com baixas taxas de recidiva. Os casos refratários tornam-se um desafio para o cirurgião plástico. Relato do Caso: MSP, sexo feminino, 53 anos, portadora de EH, refratária à DMV, e com queixas de flacidez dos dois terços inferiores da face. Foi submetida à ritidoplastia, neurectomias e miectomias seletivas. Obteve-se ausência completa dos espasmos, manutenção da mímica facial e rejuvenescimento facial. A ritidoplastia cérvico-facial associada a neurectomias e miectomias mostrou-se eficaz no tratamento do EH.

The peripheral facial palsy is a disease that can leave significant aesthetical and functional sequelae in patients. According to medical literature, Bell’s palsy (BP) is the most common cause, representing from 50 to 80% of the cases. However, it must be considered as an exclusion diagnosis. A slightly higher prevalence is estimated in women and its incidence is bimodal with peaks in the third and eighth life decades. Most patients recover within weeks, though a worsening degree may be common in the first 48 hours. Treatment must be performed to prevent complications and the medical procedures are not universally accepted. The following have been mentioned as BP risk factors: arterial hypertension, mellitus diabetes, pregnancy, puerperium and infection caused by type I herpesvirus. Although there are several BP associated risk factors, regarding face-lifting surgery there is only one reported case in medical literature. Case Report: In the present study, the authors describe the second case of Bell’s palsy after face-lifting surgery.