Репозитарій

The aim: To detect the ultrasonographic signs of necrotizing fasciitis (NF) suitable for its early diagnosis. Materials and methods: Eigty two patients with soft tissue infection, including 14 with necrotizing faciitis, were examined by ultrasonography at the admission. Ultrasonografic features were compared to intraoperative findings by the same surgeon.

Results: The thickening of subcutaneous tissue had high sensitivity (100%), but low specificity (5.8%). The hypoechoic and hyperechoic zones had the shape of “cobblestone” with sensitivity – 78.5%, specificity – 33.8%. Higher specificity (69.1%) had sign of “cobblestone separation” on two layers. The presence of fluid above the fascia (sensitivity – 71.4%; specificity – 69.1%), thickening of the fascia (sensitivity – 85.7%; specificity – 58.8%), indistinctness of the fascia edges (sensitivity – 85.7%; specificity – 66.1%) and loss of fascial homogeneity (sensitivity – 71.4%, specificity – 66.1%) were noted in early stages of NF. Advanced cases of NF were accompanied by the dissection of thickened fascia with a strip of fluid (sensitivity – 57.1%, specificity – 92.6%) and accumulation of a fluid under the fascia (sensitivity – 28.5%, specificity – 95.5%). The muscles thickening (sensitivity – 28.5%; specificity – 67.6%), skin thickening (sensitivity – 57.1%; specificity – 58.8%), and loss of the skin’s lower edge clarity (sensitivity – 57.1%; specificity – 63.2%) don’t have diagnostic value without other signs of NF.

Conclusions: Point-of-care ultrasonography allows visualization of soft tissue changes that may be hidden in the initial stages of necrotizing fasciitis and should be recommended for implementation as mandatory method of examination in patients with suspected surgical soft tissue infection.

 INTRODUCTION: Odontogenic inflammatory processes constitute a significant part among maxillofacial disorders, as well as among all inflammatory processes in organism. The author used hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
AIM OF THE STUDY. To conduct cytological assessment when applying hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
STUDY SUBJECT AND STUDY METHODS. 50 patients with odontogenic abscesses and phlegmons of maxillofacial area had been examined. To study the dynamics of the inflammatory process, cytology was performed on days 1, 3, 5, 7, 10.
STUDY RESULTS AND THEIR DISCUSSION. No differences were found in both groups of patients on the first day of treatment. On the second or third day, there was a higher number of red blood cells and a significant decrease in the number of neutrophilic granulocytes in the study group than in the comparator group. In the fibrin strands, accumulation of single macrophages, histiocytes, fibrocytes and monocytes were noted. During analysis of cytograms, an increase in the number of erythrocytes, histiocytes, fibroblasts, almost complete absence of neutrophilic granulocytes and single macrophages in the main group were observed on the 4-5 day, indicating the formation of granulation tissue and accelerated onset of proliferation. On the sixth day, patients of the study group had almost no neutrophils and no signs of inflammation, unlike patients in comparator group.
CONCLUSIONS. Cytology results has shown that application of hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons accelerates the healing time of postoperative wounds. 

 INTRODUCTION: Odontogenic inflammatory processes constitute a significant part among maxillofacial disorders, as well as among all inflammatory processes in organism. The author used hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
AIM OF THE STUDY. To conduct cytological assessment when applying hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons.
STUDY SUBJECT AND STUDY METHODS. 50 patients with odontogenic abscesses and phlegmons of maxillofacial area had been examined. To study the dynamics of the inflammatory process, cytology was performed on days 1, 3, 5, 7, 10.
STUDY RESULTS AND THEIR DISCUSSION. No differences were found in both groups of patients on the first day of treatment. On the second or third day, there was a higher number of red blood cells and a significant decrease in the number of neutrophilic granulocytes in the study group than in the comparator group. In the fibrin strands, accumulation of single macrophages, histiocytes, fibrocytes and monocytes were noted. During analysis of cytograms, an increase in the number of erythrocytes, histiocytes, fibroblasts, almost complete absence of neutrophilic granulocytes and single macrophages in the main group were observed on the 4-5 day, indicating the formation of granulation tissue and accelerated onset of proliferation. On the sixth day, patients of the study group had almost no neutrophils and no signs of inflammation, unlike patients in comparator group.
CONCLUSIONS. Cytology results has shown that application of hydrogels saturated with silver ions and an antioxidant drug for local treatment of odontogenic abscesses and phlegmons accelerates the healing time of postoperative wounds. 

 The aim of the study eas to standardize the ultrasonography (USG) protocol for TMJ and masticatory muscles (MM) examination by unifying the clinically relevant USG parameters, determining their norms, and considering gender differences. The study involved 63 volunteers. The selected individuals with normal dental occlusion were divided into two groups: 26 females and 27 males. A 12L3 linear transducer with a frequency of 2.9 to 11.5 MHz (SIEMENS Acuson Juniper) was used. The following USG parameters with clear interpretation were studied: capsular width, condylar translation amplitude, thickness of MM at rest and contraction, percentage of MM thickening at contraction, the condyle and disc position at open and closed mouth, movement of the condyle and disc during mouth opening,
subchondral cartilage complex. No signifcant differences were found between the right and left TMJ and MM
parameters in both groups. A signifcant difference in USG parameters was observed between males and females, except for the amplitude of TMJ condyle translation and the percentage of MM thickening. On the basis of the obtained results, a standardized USG protocol for TMJ and MM was proposed, allowing a high-quality comprehensive USG examination of TMJ and MM structures in patients suspected of temporomandibular disorders.