It is generally accepted that dermoid and epidermoid cysts are the result of malformation of the ectoderm. The asymptomatic course, absence of pathognomonic symptoms and similarity of clinical manifestations at separate stages of growth, despite nosological form and place of occurrence, give this pathology of particular relevance in the practice of pediatric maxillofacial surgery. However, if there are no significant issues regarding the etiology and pathogenesis of dermoids and epidermoids, there is a problem of constant monitoring of their prevalence and structure for the formation of administrative organizational measures for the planning of specialized care for this category of patients. Special attention should also be given to the development of new, minimally invasive surgical interventions, given the increasing aesthetic demands and requirements of patients. The aim of the study is to study in a comparative aspect their own experience on the clinical and morphological features and principles of treatment of dermoid and epidermoid cysts of the maxillofacial area and neck in children with the results of scientific studies, covered in literature. A thorough analysis of fundamental scientific works and publications in periodicals devoted to the scientific development of various directions in relation to these issues is carried out. The clinical section of the work concerns 15 children with dermoids and 8 children with epidermoids who have been treated for 8 years in the surgical ward of the children's clinical hospital in Poltava. General clinical, additional, and specific examination methods were used to establish clinical diagnosis, including diagnostic puncture, ultrasound, and MRI examination, which was performed in complex and questionable cases. If it is necessary, the patients are consulted by doctors of related specialties. The microscopic structure of the postoperative material was studied on preparations made by conventional methods. An objective study found that the clinical picture of the dermoid and epidermoid cysts is similar, differing only in slight subjective sensations on palpation. Comparison of clinical diagnosis and results of postoperative morphological verification of removed soft tissue bones showed that in 23.9% of patients the clinical diagnosis did not coincide with pathohistological. The difference in dermoids was the largest (75.0%), which confirms the need for expanded use of additional examination methods both at the pre-hospital stage and under inpatient conditions immediately before surgery. In general, the obtained morphological picture of the postoperative material coincided with the literature data on the classical structure of the dermoid and epidermoid cysts of the soft tissues of the maxillofacial area. Thus, the dermoid and epidermoid cysts of the maxillofacial area in children, having a dysontogenic origin, are most often diagnosed at younger and older school age. Despite their classic clinical picture, a considerable number of discrepancies between clinical and pathohistological diagnoses are traced , requiring a careful examination at both the hospital and hospital stages using modern, informative supplementary and special methods of investigation in complex and doubtful cases of cases and complex cases. These materials may be the basis for further in-depth scientific studies on immunohistochemical structural features dermoids and epidermoids to determine immunocompetence layers cystic membranes and determine their probable role in causing acute inflammation depending on the type of formation.
Neuroblastoma in newborns is a fairly rare disease and affects 6-8 children per million children. It can be combined with congenital defects, has a tendency to metastasize and to spontaneous maturation in ganglioneuritis, which can simulate various diseases and significantly complicate its diagnosis. This publication provides clinical observations of a newborn baby with a neuroblastoma located in the maxillofacial area. Attention is drawn to the difficulties encountered in establishing a clinical diagnosis, to address questions about this, it is recommended that modern, highly informative methods of examination be more widely involved in examining such children, preferably in the early stages of the disease. Against the background of an unceasing increase in the number of malignant neoplasms of the maxillofacial area among the Ukrainian population, directly among the residents of the Poltava region, this figure is 2.3% of the total number of newly diagnosed malignant formations. Asymptomatic course and "erosion" of clinical manifestations of tumors at their initial stages of development, the untimely treatment of patients with specialized assistance against the background of inadequate awareness among citizens and healthcare professionals in this section of medicine and their lack of oncological anxiety leads to the fact that a significant proportion of patients falls on treatment with abandoned forms. In particular, according to the statistical reporting of the Poltava regional oncologic dispensary at stages III and IV, the malignant process in the tissues 41.6%, of which 54% is cancer of the oral mucosa, from 28%, where the cancer of the tongue is in 10% of cases of lung cancer and 8% diagnosed salivary gland cancer. It is rather unfortunate, but in 55% of the observations, the cause of late treatment is organizational and methodological disturbances: not enough complete examination of patients, to the hospital stage (underestimation of clinical data, X-ray changes, incorrect interpretation of the results of additional methods of examination), insufficient prophylactic work among the general population or a sequence of its planning, poor quality preventive examinations, delayed patients in the grass-roots of medical institutions. In spite of the fact that a significant proportion of organs and tissues of maxillofacial area are available for objective and application of additional methods of examination, about 40% of patients have launched forms of malignant processes due to the faults of doctors [2, 3, 5, 8]. In nursery practice, the situation does not look better, since in Ukraine, 3.5% of cases of malignant tumors are diagnosed annually in Ukraine. Unfortunately, in periodicals there are isolated data on primary and metastatic lesions of maxillofacial area in children, although the recognition and treatment of oncosomatic diseases in them in the early stages of development to date present considerable difficulties due to the large variety of clinical manifestations of tumors, age-specific features, dependence of diagnosis malignant neoplasms from the dynamics of growth, localization, local and general changes [6,7]. Therefore, in our opinion, the number of diagnostic errors in children's practice is greater than in adults. The problem is of general medical significance also because, due to topographic and anatomical features of the structures of the head and neck, any pathology of maxillofacial localization is the subject of participation of doctors in various related specialties. Thus, the given clinical case indicates the possibility of a malignant effect of tissues and organs of a child already during the period of fetal development, which greatly complicates the diagnostic procedure and should alert doctors of all specialties.
The great diversity of the jaw cysts makes the issues of their diagnosis, differential diagnosis, and treatment quite important, always requiring an individual approach, given the features of each clinical case. Although the jaw cysts were first mentioned by Scultetus in 1654, the researchers still have different views on the semiotics and classifying individual nosological forms and, consequently, on choosing treatment methods, preventing possible complications and recurrences, and making prognosis. Asymptomatic clinical course and absence of characteristic clear clinical manifestations of the jaw cysts and similarity of their signs at separate developmental stages regardless of the nosological form and origin site make this pathology relevant in the practice of maxillofacial surgery. Traumatic and aneurysmal pseudocysts are common in the nomenclature of tumor-like formations of the jaws. The paper is concerned with the etiology and pathogenesis, clinical morphological features, and modes of treatment of traumatic and aneurysmal jaw cysts, based on the generalization of the findings of the scientific researches, to emphasize the above nosological forms to the medical community. The study encompasses a thorough analysis of the fundamental scientific works and publications in periodicals on the above issues. The clinical part of the study concerned a comprehensive examination of 46 children with traumatic and aneurysmal jaw cysts who received treatment at the surgical unit of the Poltava Municipal Children’s Clinical Hospital during the period of 5 years. In addition, 8 adult patients with traumatic cysts were examined and received outpatient treatment at the Department’s clinic. Common clinical and additional examination methods, diagnostic puncture, EOD, radiography, CT, and MRI were used to make the clinical diagnosis in serious cases. The microscopic structure of the specimens made from the postoperative material using conventional techniques was studied. During 2014-2019, 46 children with non-odontogenic jaw cysts (NJC) were treated at the Department of Children’s Oral Surgery, including 24 patients (52.2%) with traumatic cysts (TC) and 15 patients (32.6%) with aneurysmal cysts (AC). That is, TC and AC accounted for 39 cases (84.8%) of NJC. At the same time, while the general age of patients with NJC ranged from 5 to 15 years, TC and AC were most common in children aged 10-15 years, which is consistent with other researchers’ data, who observed the highest incidence in puberty. 25 (64,1%) boys and 14 girls (35.9%) have been involved in the study. Generalized statistical analysis revealed that traumatic cysts accounted for 52.2% of children, 32.6% for aneurysmal and 15.2% for other types of non-odontogenic jaw cysts. The patients were predominantly males, and even trauma in the past medical history did not always correspond to and confirm the type of cystic formation. The presented material suggests a rather unclear diagnostic “boundary” between traumatic and aneurysmal cysts, when, in fact, the main differential diagnostic criterion is a carefully gathered anamnesis, even at the prehospital stage. The given material can be the basis for further in-depth scientific and practical studies on immunohistochemical structural features of traumatic and aneurysmal jaw cysts.
The aim of the work is to determine the frequency, structure, features of clinical manifestations and treatment of bitten wounds of the face and neck in children of Poltava region. Materials and methods: It has been analyzed 91 histories of disease of thematic patients undergone treatment at the Surgical Department of Pediatric town clinical hospital of Poltava. Results: In the structure of traumatic injuries of maxillofacial area in children 5.3% were patients with bitten wounds of the face and neck. Among the injured were children of the age 7-12 years old (30.2%). In 74.7% of cases, the bites were complicated by acute inflammatory processes. Urban residents accounted for 71.8% of the total number of cases, while rural residents accounted for 28.2%. Boys were injured by 53.6% and girls by 46.4%. Sharps (74.5%), punctures (19.3%) and lacerations (6.2%) differed in form. The comprehensive treatment of patients with bitten maxillofacial area wounds was carried out according to the protocol of care. Conclusions: The clinical picture and severity of bitten wounds of maxillofacial area in children have individual features, which are largely due to topographic and anatomical localization of injuries. The choice of the optimal variant of primary surgical treatment of wounds and the amount of surgery should be determined individually depending on the severity of the injury, the time of injury. Special attention should be paid to normalization of psycho-emotional state of patients and prevention of scar formation.
Introduction: According to modern standards of treatment of malignant neoplasms conducting polychemotherapy requires up to 90% of cancer patients. However, in addition to the expected cytotoxic effects, it is accompanied by disorders in dental health in the vast majority of patients. The aim: To study the effect of cytostatics on soft tissues of the oral cavity in children with malignant tumors of the abdominal cavity. Materials and methods: Material for writing this scientific work served as a synthesis of results for 25 people aged 7 to 15 years with malignant tumors of the abdominal cavity, in which a comprehensive oral examination was performed to determine the manifestations of dental toxicity cytostatics. Results: At the end of the first course of chemotherapy, all patients had dry redness of the lips, 20 - (80,0%) with eruptions, in 18 - (20,0%) erosion. The Green-Vermillion, PMA, and PBI indices grew by 1,8; 7 and 3,3 times respectively. In cytograms with buccal epithelium an increase in the number of cells of polymorphic sizes and forms with signs of gidropic dystrophy was found. The nuclear-cytoplasmic ratio decreased by 1,4 times compared with the primary examination. Conclusions: This situation creates the preconditions for the development of inflammatory process in the tissues of the oral cavity and requires the use in this category of patients of a substantiated pathogenetic correction of existing disorders.
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