[Universal scoring system for assessing speech function in patients with cleft palate at the stages of surgical treatment]. / Universal'naya ball'naya sistema otsenki rechevoi funktsii u patsientov s rasshchelinoi neba na etapakh khirurgicheskogo lecheniya.

OBJECTIVE: To develop a universal system for assessing the speech function in patients with congenital palatal cleft in the postoperative period. MATERIALS AND METHODS: A universal system for assessing the speech function for patients with a palatal cleft can be applied both after the primary operation of uranoplasty and for patients diagnosed with velopharyngeal insufficiency (VPI). The patient's speech is assessed according to the following criteria: defects in the pronunciation of consonants by place of articulation: labial, labiodental, lingual-dental, lingual-palatal, lingual-alveolar; speech breathing; tongue position; directed air stream; voicing disorders; The patient's is also evaluated for the following findings: hypernasality (reflected speech); hypernasality (spontaneous speech); hyponasality; pharyngeal reflex; audible nasal emission/turbulence; facial grimaces; speech intelligibility. The speech therapy and dental assessments are added to obtain a value characterizing the patient's condition: from 0 to 10 scoring indicates than only speech therapy correction is needed; from 11 to 18 - the decision on the necessity of surgical treatment is made by the surgeon together with the speech therapist, from 18 to 25 - surgical treatment is necessary with subsequent sessions with a speech therapist. RESULTS: With the help of this questionnaire, the operating surgeon can more accurately and objectively assess in dynamics the result of the surgical treatment, regardless of the results of speech therapy treatment in the postoperative period. The creation of this scoring system for speech assessment is aimed at objectivizing the results of uranoplasty and speech-improving operations. It allows the surgeon to compare the effectiveness of different surgical methods. CONCLUSION: The universal scoring system for assessing the state of speech function can be applied in the diagnosis of a patient with a palatal cleft both after the primary operation on the palate and after corrective surgical interventions. It allows monitoring progress and identifying dynamics in surgical and speech therapy treatment.

[The use of modern dressings after complex treatment of malignant tumors of the maxillofacial region]. / Primenenie sovremennykh perevyazochnykh materialov posle kompleksnogo lecheniya zlokachestvennykh novoobrazovanii chelyustno-litsevoi oblasti.

The number of patients with malignant tumors of the head and neck is constantly growing. However, after a favorable outcome of complex treatment patients may experience adverse consequences. Surgeon should understand conditions of surrounding tissues that have undergone radiation therapy. It is necessary for special management because regenerative potential of postoperative wounds decreased. The search and development of effective wound dressings are aimed at reducing the risks of postoperative complications and improving the quality of life of this group of patients.

[Post-Covid osteomyelitis of the facial bones]. / Postkovidnyi osteomielit litsevykh kostei.

The pandemic of coronavirus infection existed from 2019 to 2023. The World Health Organization (WHO) has announced on May 5, 2023 that the pandemic had ended. However, it does not cease to have an adverse effect on the health of the world population. Necrotic lesions of the bones of the facial skeleton are now a characteristic sign of a severe coronavirus infection. We conducted a review of scientific publications that reflected the relationship between coronavirus and necrotic processes of the skull bones, methods of treatment, prevention and the latest developments in this direction. The purpose of this article is to review existing studies on Post-Covid osteomyelitis of facial bones, its impact, features of the clinical picture of this disease, analysis of methods and means of treatment of this group of patients. Analysis of literature data has shown that the search for an ideal dressing material continues, especially the developments of native developers stand emphasized. The advantages of modern materials over traditional ones have become unquestionable, but further research in this direction is required.

[The effects of a total TMJ endoprosthesis on the contralateral condyle]. / Vliyanie dvukhkomponentnogo endoproteza visochno-nizhnechelyustnogo sustava na kontralateral'nyi myshchelkovyi otrostok.

OBJECTIVE: To correlate the magnitude of the amount of translation of prosthesis and the native joint, and the postoperative change in the volume of the contralateral condylar process after unilateral total joint replacement. MATERIAL AND METHODS: The study examined 16 patients with post-traumatic jaw deformation treated with unilateral TMJ replacement using total endoprosthesis. The mandible kinematics was recorded using the Cadiax Diagnostic system and correlated with the remodeling of the native joint. RESULT: On average, the group showed an 8.5% decrease in the volume of the native condylar process. In 13 patients, the amplitude of the native joint movement in the mouth opening and the mandible pro- and laterotrusion markedly deviated quantitatively that combined with the translational movement of the TMJ endoprosthesis in all types of mandibular abduction in all the patients. Correlation analysis showed a moderate negative relationship (r= -0.43) in opening the mouth between the amplitude of movement of the native joint and of the endoprosthesis, as well as a noticeable negative strength of relationship. Also, the correlation analysis showed a moderate positive relationship between the change in the native condylar process volume and movement amplitude when opening the mouth, and an inverse correlation of the high strength of relationship between the change in the native condylar process volume and movement amplitude of the TMJ endoprosthesis. CONCLUSION: Electronic axiography found that patients in the postoperative period could restore some of the translational movements even with the attachment of the lateral pterygoid muscle cut off. The main factor influencing the magnitude of the endoprosthesis translational movement is the design of the fossa component: the ratio of the circumferential surface of the fossa to the diameter of the head of the endoprosthesis, as well as the presence of lateral stoppers. The study showed that unilateral TMJ reconstruction provides changes in the volume of the native joint directly related to the amplitude of the movement of the joint itself and inversely correlated with the amplitude of the movement of the endoprosthesis.

[Surgical treatment of a patient with mandibular micrognathia accompanied by obstructive sleep apnea syndrome using extended genioplasty]. / Khirurgicheskoe lechenie patsienta s mikrognatiei nizhnei chelyusti i sindromom obstruktivnogo apnoe vo sne metodom rasshirennoi genioplastiki.

A method for diagnosing, planning and surgical treatment of patients with micrognathia of the mandible with physiological occlusion is proposed, which makes it possible to objectively assess the severity of the anomaly and concomitant functional disorders of external respiration in the nasopharynx and oropharynx, as well as to identify the pathophysiological mechanisms of obstructive sleep apnea syndrome (OSAS) and develop an optimal surgical treatment plan with high functional and aesthetic results.

[Applications of the lipofilling method in the rehabilitation of patients with defects and scar deformities of the terminal part of the nose]. / Primeneniya metoda lipofilinga v reabilitatsii patsientov s defektami i rubtsovymi deformatsiyami kontsevogo otdela nosa.

A clinical case of the treatment of a 30-year-old patient with a diagnosis of a defect and cicatricial deformity of the terminal part of the nose, deviated septum with a defect in the cartilaginous part, valvular insufficiency and hypertrophy of the inferior turbinates is presented. Reconstructive surgery of the terminal part of the nose using cartilage autografts required special preparation of scar soft tissues of the nose. For this purpose, the method of lipofilling was used as an additional stage in the complex rehabilitation of patients with postoperative defects and deformities of the terminal section.

[Methodology for the use of kinesiological decongestant dressing in double-jaw orthognathic operations]. / Metodika primeneniya kineziologicheskoi protivootechnoi povyazki pri dvukhchelyustnykh ortognaticheskikh operatsiyakh.

OBJECTIVE: Development and implementation in practice of a technique for applying a postoperative decongestant kinesiological bandage. MATERIALS AND METHODS: A comparative analysis of the effectiveness of the developed methodology was carried out. Three groups of patients were formed, consisting of 20 people. The first group of patients received a kinesiological bandage after surgery. The second group used a pressure bandage, while the third group used a chilotherapeutic cooling mask. RESULTS: The average value of the volume of postoperative edema (in cm) on the 5th day after surgery was 10.9 in the first group; 11.4 in the second group; 11.1 in the third group. On the 10th day the corresponding values were 10.7, 11.2 and 11 cm in the third group. CONCLUSIONS: The revealed indicators of average values in the three studied groups proved that the proposed method of applying the decongestant kinesiology dressing has the most pronounced effectiveness in the postoperative period.

[Three-dimensional assessment of positional changes of the mandibular condyles following orthognathic surgery]. / Trekhmernaya otsenka izmeneniya polozheniya sustavoobrazuyushchikh elementov nizhnei chelyusti v rezul'tate ortognaticheskoi operatsii.

THE AIM THE STUDY: This study aims to assess the postoperative condylar displacement after orthognathic surgery using three-dimensional analysis of computed tomography. MATERIAL AND METHODS: This retrospective study included 64 condyles from 32 patients with skeletal Class II (Group 1, n=16) and III (Group 2, n=16) deformities. All patients underwent a bimaxillary surgery. The three-dimensional CT images were evaluated to assess condylar displacement. RESULTS: The condyle exhibited mainly superior and lateral torque immediately after surgery. Posterior displaced condyles were found in two cases in group 1 (Class II malocclusion). CONCLUSION: The present study found the condyle displacement that can be mistaken as posterior displacement of condyle in analysis of sagittal sections of CT scans.

[Determining the degree of risk of postoperative complications in patients with a benign tumor of the parotid salivary gland]. / Opredelenie stepeni riska vozniknoveniya posleoperatsionnykh oslozhnenii u patsientov s dobrokachestvennoi opukhol'yu okoloushnoi slyunnoi zhelezy.

THE AIM OF THE STUDY: Determination of the risk of postoperative complications in patients after surgical treatment of benign neoplasms of the parotid salivary glands. MATERIAL AND METHODS: The results of treatment of 228 patients with benign neoplasms of the parotid salivary gland in the period from 2019 to 2021 were analyzed. A questionnaire of 7 questions was formed the answers to which allowed patients to be assigned to a certain risk group: low, medium, high or extremely high. This gradation allows choosing the optimal method and scope of surgical treatment for each patient individually. RESULTS: Patients of the first and second groups (low and medium risk) are characterized by the occurrence of temporary isolated facial nerve dysfunction with a short recovery period (up to 1 month), as well as sialocele associated with the preservation of a fragment of the gland. For the patients of the third and fourth groups (high and extremely high risk) in which parotidectomy was performed typical features included persistent paresis of facial muscles and facial soft tissue asymmetry. CONCLUSION: A personalized approach based on determining the degree of risk of postoperative complications helps surgeon in deciding on the scope of surgical treatment from subtotal resection to total parotidectomy.

[Condylar displacement following orthognathic surgery]. / Dislokatsiya sustavnykh golovok nizhnei chelyusti v rezul'tate ortognaticheskoi operatsii.

The overview of the current literature in the research of mandibular condyle displacement after orthognathic surgeries was done. The correct postoperative mandibular condyle position is considered as one of the determinants of the stability of treatment results.

[On the occasion of 100 years of foundation of Maxillofacial Surgery Clinic of the Central Research Institute of Dentistry and Maxillofacial Surgery]. / K 100-letiyu sozdaniya otdeleniya chelyustno-litsevoi kliniki FGBU NMITs «TsNIIS i ChLKh¼ Minzdrava Rossii.

The paper presents the history of the maxillofacial surgery in the walls of Maxillofacial Surgery Clinic of the Medical and Prosthetic Institute and later in the Central Research Institute of Dentistry and Maxillofacial Surgery.

[Complications in the surgery of the parotid salivary glands. Causes, mechanisms of development, methods of prevention]. / Oslozhneniya v khirurgii okoloushnykh slyunnykh zhelez. Prichiny, mekhanizmy razvitiya, sposoby profilaktiki.

Operations for neoplasms of the parotid salivary gland require from the surgeon a deep knowledge of the anatomical and topographic features of this area and technical skill, which puts it in a number of «jewelry¼ operations that require patience and concentration. The review is devoted to the topic of specific postoperative complications after parotidectomy or subtotal resection of the gland. These include relapses of tumors, paralysis or paresis of facial muscles, Frey syndrome, salivary fistulas or sialocele, violation of skin sensitivity, soft tissue deformity. The review presents the frequency and causes of complications, mechanisms of their development, methods of prevention and elimination.

[The use of magnetic sensory system for mandibular movement patterns recording in patients after TMJ reconstruction]. / Ispol'zovanie magnitno-sensornoi sistemy dlya registratsii patternov dvizheniya nizhnei chelyusti u patsientov, perenesshikh rekonstruktsiyu visochno-nizhnechelyustnogo sustava.

OBJECTIVE: The aim of this study was to record mandibular kinematics in patients after total TMJ endoprosthesis using a magnetic sensory system. MATERIAL AND METHODS: The movement of the mandibular was examined in 10 patients who underwent TMJ reconstruction using total endoprostheses. The condylar range of motion, the angle of the transversal condylar inclination (TCI), the speed of joint movement (max S) and the stability distance between the position at the beginning of movement and at the end (Start/end) of TMJ prostheses and native joints were measured 1 week before surgery (T0) and 12 months after (T1). RESULTS: The study showed an increase in the linear distance of the native joint when opening (p=0.004), protrusion (p=0.004), balancing side (p=0.001) and max S of the native joint and endoprosthesis when opening (p=0.009), working side (p=0.008) and balancing side (p=0.001). A decrease in indicators was observed in the Start/end of the native joint when opening (p=0.035), protrusion (p=0.02), working side (p=0.004), as well as the endoprosthesis relative to the pathological joint when opening (p=0.028), protrusion (p=0.001) and balancing side (p=0.003). CONCLUSION: In the present study, in all cases, a slight but clearly defined translational shift on the side of the intervention was detected on the control condylograms, which can be referred to as «pseudotranslation¼.

[Temporomandibular joint replacement: old ideas and new concepts]. / Rekonstruktsiya visochno-nizhnechelyustnogo sustava s primeneniem alloplasticheskikh materialov: starye idei i novye kontseptsii.

This systematic literature review presents the history of the development of temporomandibular joint reconstruction, discusses the problems and difficulties faced by engineers and surgeons. Better understanding of the history of temporomandibular joint prostheses explains the origin of negative public opinion about the prosthesis. TMJ prostheses design evolution and used biomaterials are discussed to justify the lack of variability of commercially available TMJ-reconstruction systems.

[The feasibility of combined lipofilling methods in the treatment of patients with facial hemiatrophy]. / Vozmozhnosti primeneniia kombinirovannykh metodov lipofilinga pri lechenii patsientov s gemiatrofiei miagkikh tkanei litsa.

The basis of Central Research Institute of Dentistry and Maxillofacial Surgery in the period from 2015 to 2018 years there were 30 patients with primary hemiatrophy (group 1) and patients with hemiatrophy after reconstructive operations (group 2) who were examined and treated. The elimination of deformation of soft tissues was performed by combination of micro-, nano- and classical lipofilling in two sessions with an interval of 6 months. To determine the deficit of tissue volume on the affected side before and at the treatment stages, a computer tomography was performed with the construction of the mathematical surface of the face. A study of the nature of the changes in the underlying structures in each group was carried out using ultrasound scanning and LDF studies. The use of non-invasive research methods allows us to track the dynamics of skin transformation. Based on the results of the treatment in 2 groups, a combination of micro-, nano- and classical lipofilling did not only increase the volume and eliminate deformation soft tissue, but also transform the quality of the skin. Thus, the combination of various lipofilling methods allowed to achieve a more stable result and increase the efficiency of treatment.

[Bone anchored auricular prosthesis for patients with grade III microtia]. / Éktoprotezirovanie ushnoi rakoviny s oporoi na vnutrikostnye implantaty u patsientov s mikrotiei III stepeni.

The aim of the study was to assess the effectivity of auricular prosthesis on intraosseous implants in patient with grade III microtia. The study included 7 patients (5 males and 2 females) aged 18 to 45 years with hemifacial microsomia and grade III microtia operated in Central Research Institute of Dentistry and Maxillofacial Surgery in 2013-2016. Number and position of intraosseous implants was determined by reverse planning based on CT representing hard and soft facial structures. Patients were followed-up for 6-36 months. Good esthetic results were obtained by minimally invasive surgical procedure and short post-op rehabilitation. However these results required meticulous virtual planning and manufacturing of surgical template. The described method promotes very fast medical and social rehabilitation of patients with severe microtia.

[Reconstructive otoplasty: differentiated approach to rib cartilage processing and ear framework formation using carving technique]. / Rekonstruktivnaia otoplastika: differentsirovannyi podkhod k vyboru metoda obrabotki autorebernogo khriashcha i formirovaniia karkasa ushnoi rakoviny pri pomoshchi karving-tekhniki.

The aim of the research was to optimize surgical rehabilitation of patients with auricle defects and deformities by the developing of differentiated approach to the choice of reconstructive otoplasty method. The study involved 30 patients with auricle defects and deformities of congenital (20 patients) and acquired (10 patients) etiology. The defects were total in 25 patients and partial in 5 patients. All patients underwent ear reconstruction with rib cartilage using carving technique. Preoperative planning was based in Doppler ultrasound of temporal region vessels, laser Doppler flowmetry, temporal skin ultrasound and 3D ribcage CT. The surgical tactic was selected according to the possibility of mastoid region skin usage or necessity of the temporoparietal fascial flap. The approach proved to be highly efficient as otoplasty outcomes were good in 80% of cases, satisfactory in 10% and unsatisfactory in 10%.

Functional disorders in patients with lip and nose deformity after cheilorhinoplasty. / Funktsional'nye narusheniya u patsientov s deformatsiei guby i nosa posle odnostoronnei kheilorinoplastiki.

Clinical analysis of the nasolabial complex in patients suffering of the unilateral cleft lip and palate deformity after cheilorhinoplasty is presented in the article. Functional disorders such as nasal breathe impairment and it's relation to the nasolabial muscle dystonia in the dependency of primary cheilorhinoplasty type are analyzed. The plan of surgical treatment as well as the postoperative rehabilitation using the botulotoxin injections is offered.

[Nasal breath recovery and rhinoplasty in cleft lip and palate patient with unilateral choanal atresia].

The paper presents the analysis of clinical case of endoscopic nasal breath restoration and elimination of the secondary cleft lip nasal deformity in 27 years old patient with unilateral choanal atresia and secondary nasal deformity after rhinocheiloplasty. Preoperative examination revealed the absence of nasal breathing on collateral side due to complete bone choanal atresia. Surgical treatment included endoscopic choanal repair, elimination of the secondary nasal deformity, septoplasty, conchotomy and lateroposition of the inferior conchae. The treatment resulted in nasal breath restoration and elimination of nasal deformity. Long-term follow-up at 1 and 12 months post-operatively proved stable positive aesthetic and functional results.

[Elaboration of health care quality criteria in maxillofacial surgery].

Criteria of quality of care in oral and maxillofacial surgery should reflect not only the quality of the repair functions of chewing, swallowing, breathing, speech, and should take into account the psycho-emotional condition of the patient; satisfaction of its appearance, quality cosmetic fill configuration of the face, tooth defects, smiles; adaptation to implants and dentures; their quality, the conditions and possibilities of their use. The application of the provisions of the international classification of functioning, disability and health in oral and maxillofacial surgery, is a condition that will allow to unify the approaches to the development of quality criteria of this type of medical care.