Analysis of efficiency of sialendoscopy in patients with sialolithiasis

The aim of this research was to analyze 106 clinical observations in which sialendoscopy was performed for diagnosis and treatment patients with sialolithiasis. This research showed, that endoscopy of the major salivary gland ductal system allows to obtain information not only on a sialolith, but also on a condition of ductal system. The obtained data define a method of further treatment. Sialendoscopy can be used not only as diagnostic method, but also as an independent method for sialolith removing or as an assistance. The possibility of sialolith removing depends on its mobility, the size of salivary stone, localization and a salivary duct condition.

[Sinus lift and dental implantation after endosurgical treatment of odontogenic maxillary sinusitis].

The long-term results of dental implant placement in patients with the history of odontogenic maxillary sinusitis are assessed in retrospective study. Maxillary sinusotomy and endoscopic surgery procedures are compared in regard to complications risks after subsequent sinus lift and dental implantation, the latter proving to be method of choice in such cases.

[Cellular and tissue reactions of the mucous membrane of the maxillary sinus in the patients presenting with odontogenic aspergillous maxillary sinusitis].

The results of this morphological study of the mucous membrane of the maxillary sinuses in the patients presenting with the non-invasive fungal form of odontogenic sinusitis revealed the signs of granulematous inflammation. Epithelium underwent metaplasia into the single-row cubic or prismatic layer. The invasive form of fungal odontogenic sinusitis was characterized by allergic inflammation with intensive infiltration of maxillary sinus mucosa by antigen-representing and effector cells.

[Structure of maxillary sinus mucous membrane under normal conditions and in odontogenic perforative sinusitis].

Methods of light, electron microscopy and immunohistochemistry were used to study the samples of maxillary sinus (MS) mucous membrane (MM) under normal conditions and in odontogenic sinusitis. To study the normal structure, the samples were obtained at autopsy from 26 human corpses 12-24 hours after death. Electron microscopic and immunohistochemical study was performed on biopsies of grossly morphologically unchanged MS MM, obtained during the operations for retention cysts in 6 patients. MS MM in perforative sinusitis was studied using the biopsies obtained from 43 patients. The material is broken into 4 groups depending on perforative sinusitis duration. Under normal conditions, MS MM is lined with a pseudostratified columnar ciliated epithelium. Degenerative changes of ciliated epithelial cells were already detected at short time intervals after MS perforations and become apparent due to reduction of specific volume of mitochondria and, rough endoplasmic reticulum, and increase of nuclear-cytoplasmic ratio. In the globlet cells, the reduction of nuclear-cytoplasmic ratio was associated with the disturbance of the secretory product release. At time intervals exceeding 3 months, epithelium underwent metaplasia into simple cuboidal and stratified squamous keratinized, while in MS MM lamina propria, cellular infiltration was increased. CD4+ cell content in sinus MM gradually increased, while at late periods after perforation occurrence it decreased. Low CD4+ cell count within the epithelium and the absence of muromidase on the surface of MS MM was detected. With the increase of the time interval since MS perforation, the number of CD8+ and CD20+ cells in MS MM was found to increase.

[Morphofunctional changes of maxillary sinus mucosa in odontogenic fungal sinusitis].

Complex morphological research of maxillary sinus mucosa in odontogenic fungal sinusitis has revealed signs of granulomatous inflammation. In epithelium occurred metaplasia of simple cubic or columnar layer. Epithelium fiber-synthetic and plastic functions showed significant down-regulation.

[General anaesthesia with sevoflurane in dental surgery with use of LMA-Flexible and LMA-ProSeal].

To compare the laryngeal mask airways (LMA), LMA - Flexible (LMA-F) and LMA-ProSeal (PLMA) with respect to airway management in dental surgery. 35 patients, with the pathology of stomatological area (cysts of the lower jaw; diseases maxillary sinus) were investigated during the operation. Anesthesia was induced with propofol, fentanyl and atracurium besylate. Anesthesia was maintained with sevoflurane and neuromuscular blockade with mechanical ventilation. The operation lasted 30-40 min. For airway management was used LMA-F in 20 patients, in 15 patients was made PLMA. There were no statistically significant differences between LMA-F/PLMA groups for SpO(2), ET CO(2) or airway pressure during anesthesia. As for the gas exchange no difference was noticed in both groups (p<0.05). Undesirable laryngo-phryngeal reflexes were not noticed in total myoplegia. The reaction of cardiovascular system while installating LMA-F and PLMA was absent. As for the gas exchange no difference was noticed in both groups (p<0.05). A correctly placed LMA-F or PLMA during general anaesthesia with sevoflurane is effective for airway management in surgery.

[Mandible bone grafting by intraoral access].

The efficiency of intraoral approach to reconstruction defects of the mandibula was analyzed. Received results testified to high efficiency of intraoral approach to bone plastic of mandibula as the way allowing to achieve decrease of number of postoperative complications, terms of rehabilitation of patients and to ensure optimum anatomofunctional and aesthetic results.

[Complications of dental filling materials egestion into maxillary sinus--diagnostics and treatment].

Frequency of dental filling materials egestion into maxillary sinus was determined. Based upon their own clinical observations sinusitis (caused by dental filling material) characteristic features were determined, as well as diagnostic peculiarities. Open and endoscopic methods of treatment were compared. Factors determining the inflammatory character of sinusitis reaction were analyzed.

[Estimation of tracheal intubation methods in patients with pathology of maxillofacial region].

In 42 patients with pathology of face cranium tracheal intubation was performed by different methods--intubation with artificial jet high frequency lung ventilation (I+AJHFV) and fiber optic intubation (FOI). It was established that more favourable conditions for intubation were created when I+AJHFV was used. FOI with preserved consciousness and spontaneous breathing in patients with pathology of maxillofacial region reduces the time factor significance but demands significant sedative preparation of the patient.

[Comparative evolution surgical accesses to temporo-mandibular joint].

In experiment on 30 corpses of adult people criteria of an operational wound (depth of a wound, a corner of operational action, an axis of operational action, a corner of an inclination of operational action) were studied at preauricularis, intrauricularis, intrauriculo-temporalis and posterior mandibullaris access to temporo-mandibular joint (TMJ). New surgical intrauriculo-temporalis access to the joint is substantrated. On the basis of the analysis of 289 operations at 268 patients the indications to a choice of surgical access were developed at various diseases and damages of TMJ.

[Efficacy of laryngeal mask use during anesthesia in cases of short-term operations in maxillofacial area].

40 patients, with the pathology of maxillofacial area were investigated during the operation. The operation lasted 60.5+/-6.8 min. Combined intravenous anesthesia with propophol, phentanil, atracrium besylate was used for all patients. The utilization of a laryngeal mask (LM) for respiratory support was used in the first group (20 patients). An tracheal intubation (TI) was made in the second group (20 patients). In total myoplegia, the installation of LM was simple. Undesirable laryngo-pharyngeal reflexes were not noticed. The reaction of cardiovascular system while installing. LM was absent unlike TI. As for the gas exchange no difference was noticed in both groups (p>0.05). After the operation the patients of the first group recovered quicker than the patients of the second group (p<0.05). It is the result of reducing the amount of relaxants in the first group (p<0.05). Hence, anesthesia with LM may be regarded as alternative method of anesthesiological provision for a maxillofacial operations of short duration.

[The treatment of patients with traumatic osteomyelitis of the mandible by using porous permeable titanium nickelide implants]. / Lechenie bol'nykh s travmatichesim osteomielitom nizhnei cheliusti s ispol'zovaniem poristykh pronitsaemykh implantatov iz nikelida titana.

Use of titanium nickelide based porous permeable implants for repair of postosteomyelitis mandibular defects is discussed. Five patients with mandibular defects of different location and extent were operated on. Surgical methods are described. A clinical example of using a porous permeable implant is offered. The implant designed as a mandible was used for repair of an extensive mandibular defect. Good immediate and remote results of operations indicate good prospects of using such implants.

[Endoscopic technologies in maxillofacial surgery]. / Endoskopicheskie tekhnologii v cheliustno-litsevoi khirurgii.

Endoscopic operations in 107 patients with numerous maxillofacial diseases are analyzed. Endoscopic technologies were used in diseases of the maxillary sinus, temporomandibular joint, injuries to the facial nerve, and cysts of the jaws. New methods for surgical treatment of mandibular fractures, zygomatico-orbital complex, cysts of the jaws are proposed. The results of utilization of endoscopic technologies in maxillofacial surgery are analyzed and their high efficacy and good prospects are demonstrated.

[Magnetic resonance tomography of temporomandibular joint]. / Magnitno-rezonansnaia tomografiia visochno-nizhnecheliustnogo sustava.

The paper shows the place of magnetic resonance imaging among other radiation diagnostic techniques in detecting abnormal changes in the temporomandibular joint. The authors' own data were based on the results of 315 examinations. The paper describes the technical features of examination of the joint and shows it possible to visualize different anatomic structures on T1-, T2- and Pd-weighted images. It also indicates the diagnostic potentialities of magnetic resonance imaging in identifying abnormal changes in the joint in its diseases and lesions. This has allowed the authors to show what is indicated for magnetic resonance imaging of the temporomandibular joint and that it is necessary to develop an algorithm of radiation diagnosis for patients with different clinical forms of joint diseases.

[Technique of X-ray computed arthro-tomography in the diagnosis of internal disorders of the temporomandibular joint]. / Metodika rentgenovskoi komp'iuternoi artrotomografii v diagnostike vnutrennikh narushenii visochno-nizhnecheliustnogo sustava.

141 patients suffering by internal derangements temporomandibular joint are surveyed with the help x-ray computed arthrotomography. The opportunity of reception of precise intra-articular elements after introduction of contrast substance allows treat results of researches with high reliability. X-ray's data received with the help CT are investigated and systematized. The features of x-ray's picture TMJ, capable to affect tactics of spent treatment, are revealed.

[Current problems in the diagnosis and treatment of injuries to the temporomandibular joint]. / Aktual'nye voprosy diagnostiki i lecheniia povrezhdenii visochno-nizhnecheliustnogo sustava.

Complex examination of 2103 patients with temporomandibular joint (TMJ) injuries was carried out. This examination included contrast arthrotomography, computed tomography (CT) and MR tomography of the TMJ. It gas been established, that in mandibular condyle fractures not only bone structures of the TMJ, but also soft tissue ones (the articular disk and capsular-ligamentous apparatus) are being injured. Our investigation has shown that condylar fractures in the region of condylar base and neck are combined with the injuries of the articular disk and capsular-ligamentous apparatus in 54.1 +/- 5.4% cases, mandibular head fractures with its dislocation--in 100%. The term "TMJ injuries" reflecting the injuries of bone and soft tissue structures of the TMJ has been introduced. The classification of TMJ injuries including TMJ contusion, mandibular dislocations, condylar and glenoid fossa fractures, the injuries of the articular disk and capsular-ligamentous apparatus has been developed. Distant results of traditional methods of treatment used in TMJ trauma have been studied and the necessity of the restoring of correct relation: glenoid fossa --articular disk--mandibular head--has been shown. The method of TMJ reconstruction consisting in the restoration of TMJ bone structures and the articular disk and capsular-ligamentous apparatus has been developed.