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Estimation of an average face zone after the primary cleft lip repair with congenital cleft upper lip and palate
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-55-56
Vokhidov Utkirbek Nuridinovich, Tashkent State Dentistry Institute Department of pediatric maxilla-facial surgery E-mail: [email protected]
Estimation of an average face zone after the primary cleft lip repair with congenital cleft upper lip and palate
Abstract: The orthodontic treatment directed on an establishment of fragments of the upper jaw in correct position, the prevention of narrowing of tooth alignments after uranoplasty, does not provide stable results and often it appears inefficient. The analysis of photos of patients under the modified scheme and computer design helps to reveal the most typical aesthetic infringements of the person, to model forthcoming changes with forecasting of optimum balance of a profile and a bite in each specific case separately.
Keywords: Congenital cleft upper lip, orthodontic treatment, face zone, children.
Congenital cleft upper lip, alveolar process, hard and soft palate, being heavy developmental anomaly of maxillofacial area, it is characterised by the expressed structural and functional infringements. Reatment of this anomaly of development remains to one of the most complicated problems of maxillofacial surgery [1; 2; 10].
Domestic and foreign scientists develop effective methods of elimination congenital cleft upper lip and palate [2] and corrections of deformation of a nose [3; 4]. The orthodontic treatment directed on an establishment of fragments of the upper jaw in correct position, the prevention of narrowing of tooth alignments after uranoplasty, does not provide stable results and often it appears inefficient [5; 8]. After primary operations on a lip and palate 35-89% of patients have deformations of a skeleton of an average face zone [3; 9]. Their elimination is impossible without orthodontic surgical treatment. However, after surgical treatment relapses are marked at 25-50% of the operated patients [6; 7; 10].
The aim of study was to study of the remote results primary cleft lip repair at children with a congenital cleft of an upper lip and palate and to reveal the most typical aesthetic infringements of an average face zone.
Materials and research methods. For a quantitative estimation of the found out aesthetic face defects at patients with a congenital cleft of an upper lip and palate after primary surgical lip and palate spent anthropometrical measurements of the person. By means of the goniometric device measured such important indicators of the person as a corner of camber of the person, nose-lip fold the corner, a corner of the bottom jaw etc. in a profile defined the Typical accessory of the person in the standard anthropometrical way, the received indicators compared also to the standard norms.
Symmetry of face zones defined on a difference of distances of the left and right halves of the face to medial-sagittal planes and between occlusion and under eye-socket planes. For this purpose, to the patient allowed to bite a ruler and spent corresponding measurements of the right and left halves of the face. Measurement of the linear and angular sizes and their mutual relations has been in total spent. For an additional estimation of infringements of a face proportion and an estimation of results of complex treatment at patients with congenital cleft upper lip and palate Studied photos of the
person (fas and a profile). For reception of exact identical photos fas and a profile, a bite and other positions of the person photographing was spent in identical conditions with use photostat. For shootings used the digital camera (Canon 14 megapicsel). Photostatic pictures received, using the standard technique with observance of the rules offered V. А. Pereversim (1989) and to insert W. Gubish (2005).
Results of research. The received photos were studied by the standard technique with carrying out of computer design. Spent formation of optimum balance of a bite and a profile of the person with use of a photo of a profile and a bite in each specific case individually. Also defined a typical accessory of the person en face and a profile, the general a facial angle, a corner of an average part of the person a corner of an alveolar part of the person. At definition of aesthetic infringements of the person ofpatients used following lines: a Drejfusa-perpendicular, lowered from a point nasion on the Frankfurt horizontal. Schwarz's line (an oral tangent) passes through points subnasal and pogonion. Linija K. K. — a tangent a line to a contour of a red border top and lower lips. Linija L. P. — «an obverse plane», passing through points nasion and pogonion. On an arrangement top and lower lips to a line of Rikettsa (an aesthetic plane) defined type of a profile of the bottom part of the person. For definition of a parity of lips used corner Z. Profile corner of person Т defined by means of a perpendicular lowered from a point nasion, and its crossing from an oral tangent (a line subnazale-gnation). Thus proceeded from the standard norm of this corner 10 C at optimum balance of the person. If this corner is more 10 C, spoke about a profile cut кзади if it is less 10 C — about a profile cut forward. All these measurements easily spent on a computer graphic representation of a head and the person of the patient. Under the described scheme photos of the person en face and a profile at all patients before operation and in the remote terms after complex treatment have been analyzed. With computer graphics use spent modelling of optimum balance of a profile of the person and a bite in each specific case separately.
Conclusions. The analysis of photos of patients under the modified scheme and computer design helps to reveal the most typical aesthetic infringements of the person, to model forthcoming changes with forecasting of optimum balance of a profile and a bite in each specific case separately.
Rerencens:
1. Amanullaev R. A. Frequency of birth rate of children with congenital cleft upper lip and palatein large regions of Uzbekistan and the Congenital and hereditary pathology of a head, the person and a neck at children//Pressing questions of complex treatment. - M., -2006. - P. 14-15.
Section 8. Medical science
2. Bessonov S. N. Rinoplasty IV: Nose correction at congenital cleft upper lip//Elite. question plastic surgery. - 2007. - T. 1, - No 15. - P. 44.
3. Bitikenova G. B. Perfection of methods of complex rehabilitation of children with a congenital cleft of an upper lip and palate since the period new born: Aftoreferat dissertation - Alma-Ata, - 1995. - 19 p.
4. Gubashieva D. R. Modern principles of rehabilitation of children with congenital cleft of the palate: Aftoreferat dissertation. - Vo-ronej, - 2009. - 23 p.
5. Heliovaara A., Ranta R., Hukki J. et al. Skeletal stability of Le Fort I osteotomy in patients with isolated cleft palate and bilateral cleft lip and palate//Int. J. Oral Maxillofac. Surg. - 2002. - Vol. 31. - P. 358-363.
6. Jidenko A. G. Rehabilitation of patients with secondary deformations of a nose: Aftoreferat. - M., - 2007. - 25 p.
7. Semenov M. G. Bone-reconstruction treatment anomaly developments of fabrics and the got deformations of maxillofacial area in children: Aftoreferat. - SPb, - 2004. - 27 p.
8. Shulmenko V. I., Verapatvelyan A. F. Ortodontic treatment children with unilateral cleft upper lip and palate they complex rehabilitation/Stomatology of children's age and preventive maintenance. - 2001. - No 3. - P. 98-101.
9. Witherow H., Cox S., Jones E. et al. A new scale to assess radiographic success of secondary alveolar bone grafts//Cleft Palate Craniofac. J. - 2002. - Vol. 39. - P. 255.
10. Wong G. B., Padwa B. L. Le Fort I soft tissue distraction: A hybrid technique//J. Craniofac. Surg. - 2002. - Vol. 13. - P. 572.
DOI: http://dx.doi.org/10.20534/ESR-17-1.2-56-57
Juraeva Zuhra Yorievna, PhD, Associate Professor of the Department of Hospital of Pediatrics Tashkent Pediatric Medical Institute, Tashkent Uzbekistan E-mail: [email protected]
Comparative analysis of the immune system at often and rarely ill children depending on the stage of disease
Abstract: The article is devoted to the study of the immune system (IS) and cytokine sta-tus in frequently ill children (FIC) in the acute phase and remission in comparison with rarely ill with children (RIC). The immune status in these children not infrequently formed were tran-siently response by Th2-type by hyperproduction of IL-4 and IL-1fi, stimulating high production of IgE by B lymphocytes IgA against decrease synthesis.
Keywords: children, immune system, cytokine status, respiratory diseases, immune cells.
Problem defeat limfoadenoid pharyngeal ring Pirogov-Waldey-er from FIC is relevant, sin-ce this tissue is morphofunctional substrate local immunity. In terms of lymphoid tissue hyperp-lasia and concomitant chronic exudative-proliferative inflammatory viral infection begins to ex-hibit the properties of the trigger, inducing infectious-dependent immunopathological condition, as well as autoimmune reactions, often manifested by at FIC [1-3].
Recent studies have shown that FIC even during clinical well-being and the absence of signs of ARI identifies distinct changes in cell-cell interactions in the immune system: signify-cantly increased the content of pro-inflammatory interleukins (IL-2, IL-4), including interleu-kins involved in chronic inflammation (IL-6, IL-8). This is accompanied by a decrease in cell cytotoxicity and increased levels disimmunoglobulinemia cells expressing receptors that induce apoptosis. In this regard, we have been set a target [4-7].
The purpose: To examine the performance of the immune system in FIC and RIC, depending on the stage of the disease in a comparative perspective.
Materials and methods. We carried out a study on the state of the immune system in children surveyed, depending on the stage of the disease (remission and relapse stage): In the group of FIC, the number of children was 28, whereas in the group (RIC) — 20.
Criteria for selection of children in the FIC group formulated in 1986 and VYu.Albitski A. A. Baranov.
• up to a year — 4 and more;
• up to 3 years — 6or more;
• 4-5 years — 5or more;
• Over 5 years — 4 and more.
This takes into account SARS, and exacerbation of chronic diseases of ENT — organs and respiratory tract (I. E. Elagina, M. R. Bogomilsky, 2004).
Immunological studies were performed at the Institute of Immunology of the Academy of Sciences of Uzbekistan. The main parameters of cellular and humoral immunity was determined by identifying the cell surface cluster of differentiation of CD3, CD4, CD8, CD16, CD19 with monoclonal antibodies Series LT (LLC ""Sorbent Service", Russia). The study of the concent-ration of serum immunoglobulin A, M, G in peripheral blood was performed according to the method Mancini G. et al (1965). Levels of cytokines (IL- 1b, IL-4 and TNFa), IgE and sIgA in nasal washes were determined by ELISA (cytokines produced by "Cytokine", St.-Petersburg). Statistical analysis of the data obtained by the methods of variation statistics, Fischer-Student
Results and discussion. The next stage of our work was to study the above immune-logical parameters, depending on the stage of the underlying disease.
Analysis of the data showed a significant difference, as in the period of exacerbation and remission in level CD3+-lymphocytes in sickly children compared to those suffering from rare (P<0,05). Also, a significant difference was observed in the reduction of
