Ogonovsky R., Mokryk O., Paterega N., Vynarchuk-Paterega V.

METHODS AND METHODOLOGIES

Scentific article

Usually acute reactive inflammation occurring in the soft tissues of maxillofacial area after surgery is accompanied by the swelling of the face. This article includes the analysis of existing methods of evaluation of postsurgical edema of soft tissues in the lateral facial area as well as the suggestions of new techniques that are based on the indicators of acute reactive inflammation area spread and also of swelling volume of the cheek. These exponents are especially important during postsurgical period for the correction of pharmacological and physical therapy. One of the new suggested methods of dynamic evaluation of postsurgical swelling of soft tissues in the lateral facial area requires the creation of individual transparent stencil that would serve as a surface for the lineation from the mandible angle to the external edge of the eye, to the nose wing, to the mouth angle and to the chin done with the multicolor markers on which the points are daily denoted. These points represent the new limits of swelling spread and are compared with each other during the dynamic process of swelling increase and decrease. The legend of so-called facial swelling map on the stencil includes: K – mandible angle, O – external edge of the eye, H – nose wing, P – mouth angle, П – the middle of the chin. The absence of the numeral (index) next to the letter (K, O, H, P, П) means that the points were put before the surgery. On the following day after surgery expected borders of swelling are marked by the points: О1, Н1, Р1, П1 with the red pen and in 48 hours after the surgery by the points: О2, Н2, Р2, П2 respectively. In case of swelling increase or decrease represented by different points put on the stencil the ruler is used to calculate the progress or devolution of postsurgical inflammation. Suggested method allows to control the local condition of the patient even distantly (for example, by phone). In conclusion, the stencil with the lines and points on it makes the changes of the postsurgical swelling size well visualized. Moreover, the instrument for the measurement of the cheek thickness is suggested. It is made of medical steel and has jointed decussate branches with the orbed dilatations and annular handles. One of the handles contains bent measurable ruler with the millimeter scale, another handle – finger fixator. The rotund dilatations on the branches of the instrument tightly flanking both to the external and internal surfaces of the cheek make possible exact positioning of the instrument on the cheek. Bent ruler and finger fixator represent the thickness of the cheek. The elaborated methods of diagnostics were approved in the clinic of maxillofacial surgery after the atypical surgical removal of mandibular third molar in 35 patients. They allowed to trace the severity of acute inflammation of soft tissues of the face in the early postsurgical period and to adjust the pharmacological and physical treatment. Practical recommendations related to the usage of described methods are worked out. They facilitate the monitoring of condition of the patients in the postsurgical period. To conclude, the suggested new objective methods of evaluation of the severity of soft tissues swelling on the face may be recommended for a wide clinical usage and the instrument for the measurement of the cheek thickness – for the industrial manufacturing.

postsurgical swelling of the face, swelling area, thickening of the cheek, atypical surgical removal of mandibular third molar

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«Bulletin of problems biology and medicine» Issue 1 part 2 (127), 2016 year, 150-153 pages, index UDK 617.52:616.74]-005.98-07