The purpose of the study was to search for data on the evolution of virtual planning of reconstruction with a fibular graft.Material and Methods. A literature search was carried out in Scopus, RSCI databases in the time interval from 1975 to 2021 using the keywords: “computer”, “surgery”, “facial”, “microsurgery”, “fibula”, “implant”, “fibular flap”, “planning”.Results. Various planning techniques with a description of technical features and estimation of advantages and disadvantages as well as methods of minimizing errors and reducing the time spent on the modeling with an improvement in functional and aesthetic outcomes were discussed. Surgical workflows of robot-assisted osteotomies of a fibular graft were described. Complications, difficulties, and the financial aspect of fibula free flap maxillofacial reconstructions were assessed.Conclusion. Virtual planning of microsurgical reconstructions using a fibular graft reduces operating time. The accuracy of graft fixation is increased and diastases between the osteotomy lines as well as between the native jaw and the graft are decreased. Planning allows surgeons to improve symmetry or keep it in the original form, thus affecting the aesthetic aspect and emotional state of the patient. Virtual planning requires certain financial costs, but the wide range of benefits should convince the professionals to use it as often as possible.

Большинство статей по паховому лоскуту опубликовано в период с 1975 по 2010 г., но с 2015 по 2022 г. количество публикаций по SCIP-лоскуту превзошло количество публикаций по паховому лоскуту. В результате поиска литературы в PubMed и РИНЦ было найдено и отобрано 30 статей, включающих информацию о 288 лоскутах из подвздошной области. Оценивались длина сосудистой ножки, диаметр сосудов, осложнения, распространенность лоскута в реконструкции головы и шеи, толщина и размер лоскута. Оба эти лоскута имеют одинаковое питание, но разный уровень диссекции. По сравнению с паховым лоскутом лоскут SCIP — superficial circumflex inguinal artery perforator (англ.: перфоратор поверхностной огибающей паховой артерии) имеет более длинную сосудистую ножку, которую можно увеличить благодаря новым методикам, что позволяет использовать его также в виде сверхтонкого лоскута. Это снижает необходимость во вторичных процедурах истончения (defatting) лоскута и позволяет снизить риск развития осложнений в донорской области. Толщина лоскута SCIP меньше, чем пахового, что, как указывают авторы, повышает эстетический уровень операций в области лица в контексте текстуры и цвета лоскута. Сосудистая анатомия SCIP-лоскута вариативна, поэтому необходимо использование предоперационного планирования. Несмотря на это, осложнения в донорской или реципиентной области при реконструкции SCIP-лоскутом минимальны. Доказано, что лоскут SCIP универсален и безопасен во всех аспектах реконструкции. Можно сделать вывод, что лоскут SCIP следует рассматривать как «рабочую лошадку» в реконструктивной микрохирургии мягких тканей челюстно-лицевой области и полости рта.

Introduction. The groin flap was the first local pedicled flap and free flap in plastic surgery. Later, superficial circumflex artery perforator flap replaced this flap. The SCIP flap has begun to be actively studied at the beginning of the 21st century. This study describes and summarizes vascular anatomy of the SCIP flap. Material and methods. Bilateral anatomic study was conducted in 24 cadavers (14 men, 10 women) to lift 47 SCIP flaps between December 2022 and November 2023. In 14 separate cadavers (4 men, 10 women), vascularization area along perforator vessels and superficial circumflex iliac artery was studied. We estimated diameter, length and course of the vessels supplying the SCIP flap, as well as the main zones of their perforation of superficial fascia. Variant anatomy of vessels was studied. Results. SCIA was detected in 43 (91.5%) out of 47 cases. Classical SCIA anatomy with origin from the femoral artery above the deep femoral artery was observed in 36 (83.72%) out of 43 cases. Mean length of SCIA was 9.2 mm (1—23.8 mm), diameter — 1.88 mm (0.75—3.75 mm). Among 14 corpses, the total area of vascularization for both perforator vessels was obtained in 14 cases, for superficial perforator vessel — in 10 cases, for deep perforator vessel — in 11 cases. Conclusion. This study describes vascular anatomy of superficial circumflex iliac artery perforator flap. A detailed knowledge of flap anatomy facilitates harvesting. We can talk about a large area of vascularization along superficial circumflex iliac artery. We also can harvest chimeric flap with a part of the sartorius muscle.

Objective. To evaluate the effectiveness of various surgical strategies for reinnervating the facial nerve in patients who have sustained post-traumatic paralysis of the facial muscles. Material and methods. The cohort included six male patients with a mean age of 29±7 years. Depending on the level of nerve lesion—whether intra- or extratemporal—patients underwent either triple selective reinnervation or reinnervation via the hyoid nerve (XII), accompanied by intraoperative neurophysiological monitoring. Results. Evaluations using the House-Brackmann scale, needle electromyography, and eFACE scores indicated statistically significant improvements (p<0.05) by 12 months of follow-up for all patients. These findings underscore the effectiveness of a tailored approach and the importance of neuromonitoring. Conclusions. The findings from this prospective study demonstrate the clinical efficacy of a differentiated surgical approach to facial nerve reinnervation in patients with post-traumatic paralysis of the facial muscles.

Objective. To summarize data on augmented reality technology in various surgical fields. Material and methods. Between 2022 and 2024, specialists in abdominal, interventional, maxillofacial, reconstructive and head & neck surgery, as well as urology performed augmented reality assisted treatment of 68 patients at the University Hospital of the Russian University of Medicine. This technology was used for preoperative planning and intraoperative navigation. Results. Integration of augmented reality did not significantly prolong surgery time. In head and neck tumor surgery, augmented reality reduced surgery time by 15%. In interventional surgery, improved spatial understanding of vascular anatomy reduced fluoroscopy time and surgery time. Likert scale assessments confirmed high usability of this technology. Conclusion. Augmented reality is effective and perspective in various surgical fields. However, this technology requires further refinement. Enhancing the precision of 3D models and spatial registration processes, improving adaptability to intraoperative anatomical shifts, and automating routine tasks will collectively increase versatility and adoption of augmented reality systems throughout surgical care.

Background: Fascicular turnover flap (FTF) is a donor-sparing option for segmental facial nerve repair. This study compared autologous nerve grafting with proximally based and distally based FTF in a rat facial nerve model. Methods: Adult male Wistar rats were randomized to autograft, proximal FTF, or distal FTF (n = 8 per group). A single additional animal with an untreated defect served as a qualitative histological reference. The prespecified primary endpoint was whisker motion amplitude at week 8; the secondary endpoints were central section histomorphometry (nerve tissue area, µm²) and variability metrics (IQR, SD, and coefficient of variation) as measures of reproducibility. Non-parametric tests (Kruskal–Wallis; Mann–Whitney U) were used; pairwise functional comparisons were Holm-corrected; and effect sizes were expressed as Cliff’s δ. Results: At week 8, the overall functional comparison was significant (Kruskal–Wallis p = 0.047), but no pairwise contrast remained significant after Holm correction. Functional recovery was highest in the autograft group, followed by proximal FTF and distal FTF. Both FTF groups showed lower inter-animal variability than autograft for the week-8 functional endpoint, with the distal FTF showing the lowest dispersion. Central section nerve area comparisons did not reach global significance; effect sizes and descriptive statistics favored autograft, and a single unadjusted pairwise contrast (autograft > proximal FTF) should be interpreted cautiously. Conclusions: Both FTF configurations achieved measurable functional and structural regeneration while avoiding an additional free donor nerve graft. Within an 8-week window, autograft remained the benchmark. Between FTF variants, distal FTF produced more stable functional outcomes, but this did not translate into superior functional recovery. Confirmation in larger, balanced cohorts with longer follow-up and vascular/neural labeling is warranted.