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.
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.
ВІСНИК Українська медична стоматологічна академія 154 the highest expression was noted in the group, where salivary gland tissue was adjacent to the salivary gland tumour (111, 93±56, 97 versus 8,12±4,4). Correlation analysis of patients with pleomorphic adenoma of the large salivary glands with different fragments of tissues samples demonstrated that the expression level of miRNA-29a differed significantly between the groups (adjacent gland -intact salivary tissue).Conclusions. A sufficiently high level of miRNA-29a expression in the tissues of pleomorphic adenoma in the large salivary glands compared with the normal (intact salivary gland tissue), 10 times as much can be used as a genetic marker for verification (identification) of this type of tumours. Studies of biopsy material from patients with pleomorphic adenoma in the large salivary glands at the genetic level (by expression of miRNAs-29a) confirm the need not only in enucleating of the tumour (partial parotidectomy), but also in performing of subtotal resection with removal of salivary gland adjacent to the tumour.
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