COMPUTER MODELING AND LASER TECHNOLOGIES IN REHABILITATION OF PATIENTS WITH MIDFACIAL TRAUMA

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Abstract

Aim: To assess the kind of damage of musculoskeletal apparatus of eye and orbit. To develop algorithm of laser therapy to restore orbital circulation and algorithm of transcranial laser therapy to improve microcirculation in maxillofacial muscles. 

Materials and methods: 75 patients with midfacial trauma were examined using laser spectrophotometry and computer modeling of orbital structures in frontal, sagittal, and inclined planes with SSD, MPR and VRT reconstructions (with Mimics software (Materialise, Leuven, Belgium)). To study orbital and maxillofacial microcirculation complex Spectrotest was used. Tissue oxygen concentration (SatO2) and blood filling volume index of microcirculation (Vbf) were measured. 

Results: After computer modeling, several variants of damage of musculoskeletal apparatus of eye and orbit were identified including oculomotor muscle entrapment in 60% of patients, angular deviation of muscle belly in 30%, muscle contusion – in 45%, orbital hematoma – in 18%, scarring of musculoskeletal apparatus of orbit – in 40%. During early period of trauma of orbital wall and maxillary sinus, Vbf decreased by a mean of 12.5 ± 0.5% compared to normal values, whereas contralateral microcirculation increased by a mean of 28.5 ± 0.1% compared to normal values. Abnormal blood distribution persisted in the long-term, after bone reposition: blood flow increase was found only in 10% of patients. In severe trauma and chronic scarring, local laser irradiation was associated with increase of Vbf bilaterally, but chronically and significantly increased SatO2 indicated impaired tissue trophics and high risk of inflammatory complications. 

Conclusion: Computer modeling is of great value in the diagnosis and rehabilitation planning in patients with injuries of musculoskeletal apparatus of eye and orbital structures. Laser spectrophotometry is useful for the monitoring of microcirculation before, after the operation and during rehabilitation.

About the authors

V. A. Stuchilov

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: va-stuchilov@yandex.ru

MD, PhD, Professor, Chief Research Associate, Oral and Maxillofacial Surgery Department

Russian Federation

A. A. Nikitin

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor, the Head of the Oral and Maxillofacial Surgery Department

Russian Federation

A. B. Sekirin

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, the Head of the Physical Therapy and Rehabilitation Department

Russian Federation

E. V. Filatova

Moscow Regional Research and Clinical Institute (MONIKI); Family Medical Clinic “Detstvo Plus”

Email: fake@neicon.ru

MD, PhD, Professor, Medical Rehabilitation and Physical Therapy Department, Postgraduate Medical School1, the Head of the Medical Rehabilitation Department

Russian Federation

K. S. Larionov

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Senior Research Associate, Physical Therapy and Rehabilitation Department

Russian Federation

A. S. Grishin

District Hospital No. 2

Email: fake@neicon.ru

MD, Physician, Oral and Maxillofacial Surgery Department

Russian Federation

V. Yu. Kokorev

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Physician, Ophthalmology Department

Russian Federation

A. A. Ryabtseva

Moscow Regional Research and Clinical Institute (MONIKI)

Email: fake@neicon.ru

MD, PhD, Professor, the Head of the Ophthalmology Department

Russian Federation

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Copyright (c) 2015 Stuchilov V.A., Nikitin A.A., Sekirin A.B., Filatova E.V., Larionov K.S., Grishin A.S., Kokorev V.Y., Ryabtseva A.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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