ABSTRACT
Odontogenic anaerobic sepsis was diagnosed using vapor-phase gas chromatographic analysis (VPGCA) for detecting volatile fatty acids--metabolites of anaerobic bacteria. The method is rapid and therefore diagnostically valuable. Rapid diagnosis of anaerobic odontogenic sepsis is to include detection of the clinical signs of anaerobic inflammation of the primary purulent focus and the clinical laboratory symptom complex of generalized infection and VPGCA of volatile fatty acids in the blood.
Subject(s)
Bacteria, Anaerobic , Focal Infection, Dental/diagnosis , Sepsis/diagnosis , Adult , Bacteria, Anaerobic/isolation & purification , Chromatography, Gas , Fatty Acids, Volatile/blood , Female , Focal Infection, Dental/blood , Focal Infection, Dental/microbiology , Humans , Male , Middle Aged , Sepsis/blood , Sepsis/microbiologyABSTRACT
A total of 283 patients with odontogenic sepsis, in 66 of these complicated with septic shock, were observed in 1983-1995. A program for rapid assessment of the main clinical laboratory parameters is proposed for differentiating the phases of shock development. Combined use of hemoperfusion and extracorporeal perfusion oxygenation of the blood with preliminary or simultaneous intraarterial infusion of plasma substitutes possessing hemodynamic effects is pathogenetically justified in septic shock.
Subject(s)
Focal Infection, Dental/diagnosis , Sepsis/diagnosis , Shock, Septic/diagnosis , Combined Modality Therapy , Diagnosis, Differential , Face , Focal Infection, Dental/complications , Focal Infection, Dental/therapy , Humans , Neck , Sepsis/complications , Sepsis/therapy , Shock, Septic/etiology , Shock, Septic/therapy , Time FactorsABSTRACT
A program of early diagnostics of odontogenic mediastinitis was developed on the basis of an analysis of clinico-laboratory manifestations and the evaluation of its clinical efficiency is given. The criteria were established for determining the phases of odontogenic mediastinitis-reactive, toxic and terminal ones. A program of complex treatment was worked out and introduced into practice which included the methods of efferent therapy-hemosorption and perfusion through xenospleen. Substantially decreased lethality (from 39.5% to 15.3%) from odontogenic mediastinitis was obtained.
Subject(s)
Focal Infection, Dental/diagnosis , Mediastinitis/diagnosis , Acute Disease , Adolescent , Adult , Aged , Cellulitis/diagnosis , Cellulitis/therapy , Combined Modality Therapy , Diagnosis, Differential , Face , Female , Focal Infection, Dental/therapy , Humans , Jaw Diseases/diagnosis , Jaw Diseases/therapy , Male , Mediastinitis/therapy , Middle Aged , NeckABSTRACT
A total of 470 patients with inflammatory diseases of the maxillofacial area and neck were examined and treated. Acute inflammatory process was complicated with sepsis in 87 of them. Clinical and laboratory studies revealed that the intensity of endogenous intoxication depended on the phase of inflammatory process. This helped accurately differentiate between the intoxication degrees and develop detoxication strategy for each of them. Such a differentiated approach helped appreciably decrease the mortality in the group of patients with odontogenic and stomatogenic sepsis.
Subject(s)
Cellulitis/therapy , Focal Infection, Dental/therapy , Furunculosis/therapy , Jaw Diseases/therapy , Sorption Detoxification , Systemic Inflammatory Response Syndrome/therapy , Acute Disease , Adolescent , Adult , Aged , Cellulitis/complications , Cellulitis/diagnosis , Combined Modality Therapy , Face , Focal Infection, Dental/complications , Focal Infection, Dental/diagnosis , Furunculosis/complications , Furunculosis/diagnosis , Humans , Jaw Diseases/complications , Jaw Diseases/diagnosis , Middle Aged , Neck , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/etiologyABSTRACT
Contact odontogenic mediastinitis is a complication of advanced phlegmons of the face and neck. 22-year experience in the treatment of 107 patients with odontogenic mediastinitis, clinical and laboratory criteria of its diagnosis and differential diagnosis with advanced phlegmons are presented. The programs of intensive therapy adjusted for the disease phase and surgical treatment contributed to lowering of lethality from 50 to 15.3%.
Subject(s)
Focal Infection, Dental/diagnosis , Mediastinitis/diagnosis , Acute Disease , Cellulitis/complications , Cellulitis/therapy , Combined Modality Therapy , Diagnosis, Differential , Face , Focal Infection, Dental/etiology , Focal Infection, Dental/microbiology , Focal Infection, Dental/therapy , Humans , Mediastinitis/etiology , Mediastinitis/microbiology , Mediastinitis/therapy , Neck , Postoperative Care , Preoperative CareABSTRACT
Intraoperative color lymphosialography was carried out in 56 patients with benign tumors of the parotid salivary gland. A characteristic staining of the gland distinguishing it from the tumor was seen during surgery in all the cases. Peripheral branches of the facial nerve were well seen too. Employment of this technique has helped reduce by half the number of x-ray contrast examinations and resulted in a lower incidence (only 5 percent) of postoperative complications.
