Liudmila Sergeevna Shamanaeva

Background Preoperative assessment of age-related changes is crucial for predicting and preventing complications and for minimizing repeat interventions, in esthetic surgery of the face and neck. However, there is still a lack of evidence-based data and quantitative information concerning the use of diagnostic methods when planning surgical rejuvenation of the face and neck. Methods This study included 73 patients who complained of age-related changes in the soft tissues of the face and neck and who sought esthetic surgical correction, between March 2022 and November 2024. Patients underwent a general clinical examination, assessment, age ranking, and gender categorization; their body mass indexes and aging morphotypes were also determined. Subsequently, a standard surgical correction plan for each patient was compared with a treatment plan obtained after cone beam computed tomography (CBCT). Results Comparisons of standard treatment plans with plans based on CBCT results revealed that the latter exhibited significant advantages (p < 0.05) when selecting methods for surgical correction of the soft tissues of the face and neck. Conclusions The use of CBCT scanning provides objective information about the condition and anatomical features of soft tissues and facial bones, enabling the planning of predictable, safe, and effective outcomes for surgical rejuvenation of the face and neck. It also helps to reduce the number of surgeries, lower treatment costs, and shorten the duration of treatment. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Recently, numerous articles have been published describing atypical lesions of the jaw bones related to treatment with medications based on phosphorus or analogs of its compounds, particularly bisphosphonates. Goal: To conduct a comparative analysis of the quality of life after radical surgery of the jaw in patients with medication-related osteonecrosis. A total of 82 patients were interviewed, of which 39 (47.6%) patients were in the control group (conservative treatment) and 43 (52.4%) patients in the main group had radical surgical treatment. The mean age of patients in both groups was 66.8 ± 10.03 years. Treatment of patients in the control group in terms of conventional conservative protocol included the local application of 0.05% chlorhexidine solution 1–2 times a day, antibacterial therapy (clindamycin—150 mg 4 times daily for 7 days) and NSAIDs (nimesulide). Patients in the main group (n = 43) underwent segmental resection of the jaw. Thirty days and then 6 months after the treatment, all patients were asked to assess the intensity of pain using a numerical scale, where 0 = no pain, 5 = moderate pain and 10 = the most severe pain imaginable, and to fill in the SF-36 Quality of Life Questionnaire. Results: An analysis of the results obtained with the Numeric Pain Rating Scale demonstrated that the mean pain intensity before treatment was 8.9 points in the control group, and 9.7 in the main group. These values were indicative of “unbearable pain”. After treatment (30 days), the pain score in the control group decreased and amounted to 4.1, which is evidence of the persistence of “moderate pain” in patients. In patients who underwent segmental jaw resection, the mean pain intensity was 0.5. There was no relationship with gender, but there was a direct relationship between the intensity of the pain and the stage of the process (CI = 95%). The SF-36 quality of life questionnaire showed that in the control group, who were treated conservatively, bodily pain (BoP) decreased from a score of 91.2 to 34.3, and the mental health score increased from 34.2 before treatment to 36.3 after treatment, which indicates the persistence of discomfort. The remaining parameters improved after treatment, but no complete recovery was achieved. Before radical surgery, the main group of patients also had a high level of bodily pain (95.2), but after surgery this decreased to 12.4. The remaining parameters also showed a significant difference before and after radical surgery, indicating a positive trend. Radical surgery allows us to improve the quality of life of patients, thereby confirming that surgical volume is a secondary aspect if there is no relapse after the treatment.

ЦЕЛЬ ИССЛЕДОВАНИЯ Оценить роль психометрических шкал в оценке удовлетворенности результатами эстетической коррекции шейно-лицевой области. МАТЕРИАЛ И МЕТОДЫ 22 апреля 2021 г. был проведен поиск литературы в базе данных PubMed с использованием поисковых терминов: «подтяжка (лифтинг, омоложение) лица, шеи», «качество жизни», «удовлетворенность пациентов». В исследование были включены статьи, опубликованные с 22 апреля 2006 г. по 22 апреля 2021 г., которые касаются методик омоложения путем подтяжки мягких тканей лица и шеи, качества жизни и удовлетворенности пациентов этими процедурами. Учитывались систематические обзоры, первичная литература и валидированные опросники. Первоначальный поиск привел к 184 статьям, после удаления дубликатов количество сократилось до 71 статьи. Для окончательного анализа была отобрана 71 (100%) статья. Из 71 статьи 22 (31%) статьи посвящены методам коррекции мягких тканей лица и шеи; систематические обзоры — 13 (18%) статей; первичная литература — 7 (10%) статей; валидированные опросники — 29 (41%) статей. РЕЗУЛЬТАТЫ В иностранных литературных источниках опубликовано множество шкал и опросников, которые позволяют проводить психометрическую оценку пациентов до и после коррекции, а также сравнивать качество жизни и удовлетворенность результатами эстетической коррекции шейно-лицевой области. В настоящее время в Российской Федерации практически не используются лингвистически валидированные опросники для оценки эффективности эстетической коррекции в области лица и шеи. Валидация (validation) — это придание, подтверждение законной силы, и для использования и внедрения в практику таких опросников нужны перевод и разрешение от разработчиков, а также соблюдение этапов валидации. Несмотря на труднодоступность и громоздкость самих опросников, является очевидным, что они необходимы для практикующих специалистов в эстетической хирургии шейно-лицевой области. ЗАКЛЮЧЕНИЕ Обзор литературы показал важность оценки удовлетворенности результатами коррекции и качества жизни, а также необходимость использования шкал и опросников как пациентами, так и хирургами. Утвержденные стандартизированные шкалы для оценки внешнего вида, качества жизни, побочных эффектов от эстетических процедур в этой области не используются по причине их малой распространенности и громоздкости. Необходимы удобные и простые для использования лингвистически валидированные опросники для оценки процедур эстетической хирургии в области лица и шеи.

Background: The question of reconstruction of human tissues and organs with the use of medical materials is still open, because of the accurate requirements for their biological and physical features. The aim of this study was to prove the efficiency of titanium nickelide constructors in treatment of isolated orbital floor fractures or combination with zygomatico-orbital complex fractures. Methods: Patients with a fracture of zygomatico-orbital complex and/or low orbital floor (n = 44) carried out different treatments: in the first group, osteosynthesis and endoprosthesis with titanium nickelide structures; in the second group, titan mini-plates osteosynthesis; in the third group (‘blow-out’), endoprosthesis with a titanium nickelide mesh; and in the fourth group (‘blow-out’), conservative treatment and monitoring (archive data) (p > 0.05). The paraesthesia, diplopia, enophthalmos and exophthalmos degree were measured in points. Results: In one year, the first and second groups had no differences in level of paraesthesia (p > 0.05). The absence of exophthalmos and differences between first and second groups, and between the third and the fourth groups with positive dynamics inside the groups were proved (p < 0.05). In the first and third groups, enophthalmos was absent, and it increased in the second and fourth groups (p < 0.01, p < 0.11). Diplopia in the first and third groups was absent, and it increased in the second and fourth groups (p < 0.05, p < 0.01). Conclusion: The elasticity and biocompatibility of titanium nickelide make the implant insertion and restoration of the lower orbital wall anatomy easier, with good postoperative clinical results.

Introduction. The treatment of chronic odontogenic maxillary sinusitis remains an important problem for medicine due to the presence of numerous available techniques, number of complex surgical approaches, performed by an ENT or maxillofacial surgeon or both. This study aims to analyse different methods of treatment of chronic maxillary sinusitis by several specialists for the choice of the optimal treatment technique. Outline of cases. We describe two clinical cases of multidisciplinary treatment of patients with chronic odontogenic maxillary sinusitis with the involvement of different specialists ? the ENT and the maxillofacial surgeon. One patient was treated with endoscopic technique, and other underwent classic open sinusotomy using local tissues and xenogenic collagen membrane for removing an oroantral fistula. For assessing the condition before and after the treatment, clinical examination and computed tomography were used. Conclusion. According to the results of our study, the endoscopic technique is the preferred method of treatment of patients with chronic maxillary sinusitis when there is no connection with the oral cavity. If an oroantral fistula is present, it is necessary to perform an open operation by a maxillofacial surgeon.

The aim of this study was to improve the efficiency of surgical treatment of patients with fractures involving zygomatico-orbital complex and maxillary sinus through the use of Foley catheter. 352 patients with fractures of the middle third of the facial skeleton were treated at the Departments of Oral & Maxillofacial Surgery in Novokuznetsk Institute and I.M. Sechenov First MSMU. All patients underwent open reduction and osteosynthesis using extramedullary titanium mini-plates and NiTi mini-clamps. In the cases with large bone defects additional reconstructive techniques were used such as replantation of bone fragments and endoprosthesis with NiTi implants. For the purpose of drainage and retention Foley catheter was placed in the cavity of the maxillary sinus after the surgical procedure. We obtained good and satisfactory results in the majority of clinical cases. The use of Foley catheter was found to be very effective for the post-operative drainage and hemostasis of the maxillary sinus and in cases involving the use of fixation implant in the reconstructive surgeries in the middle third of the face.

The treatment plan for patients with mid-face fractures was presented in this article. In maxillofacial department of the I.M. Sechenov First Moscow State Medical University we used nickelid titanium mesh for reconstruction of the orbital floor. The clinical case with good result of treatment was presented here.