The objective of the present study was to develop and introduce into the clinical practice the method for the combined aesthetic and functional rehabilitation of the patients presenting with congenital atresia of the external auditory canal (CAEAC) and the concomitant microtia. A total of 8 patients at the age from 6 to 21 years with unilateral CAEAC and microtia were given the surgical treatment. During the intervention, atresia was resolved using the trans-mastoid approach, tympanoplasty of autofasciae and ossiculoplasty making use of the partial titanium prosthesis and the placement of cranial osteointegratable titanium implants. At the second stage of the surgical intervention the 3D silicone prosthesis of the auricle shaped on an individual basis were used. The long-term follow-up observations have demonstrated the stable formation of the tube of the external auditory canal, with the bone-air interval amounting to 15-20 dB. The auricular prosthesis was the mirror image of the natural ear and completely concealed the congenital defect.

Background. One of the most difficult in the clinical practice patients groups are patients with orofacial pain. A possible cause of pain in the face and mouth can be stylohyoid syndrome or Eagle syndrome. The clinical manifestations of the syndrome are observed in only 4-10.3% of cases among the total number of cases of elongated hyoid processes. Objective. To develop criteria for the choice of the surgical access for a safe removal of the hyoid process depending on its anatomy. Methods. In patients with the symptoms of stylohyoid syndrome, in the case of detecting an extended hyoid process during the clinical study, its removal was performed via an intraoral route (n=3). In the other patients (n=10) the removal was performed via an external access along the first cervical fold, or through the vertical retroaural access. Results. In patients with stylohyoid syndrome, we observed a high efficiency of the surgical treatment and rather short times of postsurgical rehabilitation, that significantly improved the quality of life. Conclusion. In our opinion, the surgical access through the first cervical fold is the most convenient way both from the technical viewpoint and from the viewpoint of a minimal cosmetic defect.

Purpose: Creation and implementation effective methods of complex anatomical, functional and aesthetic rehabilitation for different categories of patients with atresia of the external auditory canal (AEAC) and microtia. Methods: Fourty seven patients (n = 47) with congenital atresia of external auditory canal and microtia of different grade underwent surgery on the base of ear diseases department of Federal Scientific and Clinical Center of Otorhinolaryngology (FSCCO) of Federal Medico-Biological Agency of Russian Federation. All patients were divided into three groups. The first group included patients with EACA and 1 grade microtia. The second group included patients with EACA and 2-3 grade microtia. The third group included patients with AECA and 2-3 grade microtia who underwent different types of surgeries previously, had unsufficient development of local tissue, history of trauma, radiation or auricular cancer. To all of them one of three surgical approaches was performed due to individual features and indications: formation of an EAC, tympanoplasty with ossicular chain reconstruction (n = 23) to the 1 st group of patient; formation of an EAC, tympanolasty with ossicular chain reconstruction and concomitant reconstruction of an auricle by use of MEDPORto the 2 nd group of patients (n = 9) or fixation of cranial osseointegrated implants (COI) to the 3 rd group of patients (n = 15). Results: During the observation period which covered on average 3.2 years ( + / -9 months) achieved stable anatomical result. The air-bone gap was on the average 17,0±3.2 dB. Medpor reconstruction provided reliable aesthetic results. The removable auricural prosthesis completely covered up a congenital defect and was a reflection of a healthy ear. Conclusion:The application of the method of lining the formed bone walls of the external auditory canal with a skin pedicled flap and free skin grafts makes it possible to achieve stable anatomical result. Ossiculoplasty with titanium prostheses and tympanoplasty with auto-fascia graft provide a significant hearing improvement in patients with congenital atresia of the external auditory canal. Simultaneous surgical interventions with atresia repair; tympanoplasty and Medpor implantation or setting of ectoprosthetic on COI can be successfully used to improve hearing, replace abnormal ear in different categories of patients according to indications and return them to the social life.

Facial graft transplantation remains the operation of choice for patients with extensive tissue defects in the maxillofacial region. This study aimed to set up an experiment on biological objects, develop and test a combined facial graft cross-transplantation technique, select the anesthetic aid allowing to reduce the risks of perioperative complications, improve survivability of the subjects by reducing the duration of surgical intervention, develop a postoperative therapy and rehabilitation protocol, assess detection of an acute rejection reaction and develop the immunosuppressive therapy protocol. We conducted three series of facial graft transplantation surgeries on 26 minipigs and tested the typical component combinations and flap designs. At all stages of the experiment, we managed to have the subjects surviving for over 30 days without disrupting their vital functions. The immunosuppression procedure was developed and tested. The chosen technique allows transplanting two grafts within a single surgery on one pair.

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