Email this article COMPUTER MODELING AND LASER TECHNOLOGIES IN REHABILITATION OF PATIENTS WITH MIDFACIAL TRAUMA
- Authors: Stuchilov V.A.1, Nikitin A.A.1, Sekirin A.B.1, Filatova E.V.1,2, Larionov K.S.1, Grishin A.S.3, Kokorev V.Y.1, Ryabtseva A.A.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Family Medical Clinic “Detstvo Plus”
- District Hospital No. 2
- Issue: No 36 (2015)
- Pages: 82-89
- Section: TRAUMATIC INJURIES IN OPHTHALMOLOGY
- URL: https://almclinmed.ru/jour/article/view/234
- DOI: https://doi.org/10.18786/2072-0505-2015-36-82-89
- ID: 234
Cite item
Full Text
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.
Keywords
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
РоссияA. 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
РоссияA. B. Sekirin
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, the Head of the Physical Therapy and Rehabilitation Department
РоссияE. 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
РоссияK. S. Larionov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Senior Research Associate, Physical Therapy and Rehabilitation Department
РоссияA. S. Grishin
District Hospital No. 2
Email: fake@neicon.ru
MD, Physician, Oral and Maxillofacial Surgery Department
РоссияV. Yu. Kokorev
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Physician, Ophthalmology Department
РоссияA. A. Ryabtseva
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
MD, PhD, Professor, the Head of the Ophthalmology Department
РоссияReferences
- Вялов СЛ, Пшеничнов КП, Куиндоз П, Монтандон Д, Питте Б. Современные представления о регуляции процесса заживления ран (обзор литературы). Анналы пластической, реконструктивной и эстетической хирургии. 1999;(1):49–56. (Vyalov SL, Pshenichnov KP, Kuindoz P, Montandon D, Pitte B. [Current concepts of regulation of wound repair (literature review)]. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 1999;(1):49–56. Russian).
- Ипполитов ВП, Мариничева ИГ. Анализ отдаленных результатов хирургического лечения посттравматических деформаций лобно-носо-глазничного комплекса. В: Материалы VII Международной конференции челюстно-лицевых хирургов и стоматологов. Санкт-Петербург, 28-30 мая 2012 г. СПб.; 2002:69. (Ippolitov VP, Marinicheva IG. Analysis of the long-term results of surgical correction of post-traumatic deformations of frontal-nasalorbital complex. In: Proceedings of the VII International Conference of Oral and Maxillofacial Surgeons and Dentists. Saint Petersburg; 2002:69. Russian).
- Fan X, Li J, Zhu J, Li H, Zhang D. Computerassisted orbital volume measurement in the surgical correction of late enophthalmos caused by blowout fractures. Ophthal Plast Reconstr Surg. 2003;19(3):207–11.
- Николаенко ВП, Астахов ЮС. Орбитальные переломы: руководство для врачей. СПб.: Эко-вектор; 2012. 436 с. (Nikolaenko VP, Astakhov YuS. Orbital facial fractures: physician guidance. Saint Petersburg: Eko-vektor; 2012. 436 p. Russian).
- Weaver AA, Loftis KL, Tan JC, Duma SM, Stitzel JD. CT Based Three-Dimensional Measurement of Orbit and Eye Anthropometry. Invest Ophthalmol Vis Sci. 2010;51(10):4892–7.
- Burnstine MA. Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol. 2003;14(5):236–40.
- Крупаткин АИ, Голубев ВГ, Панов ДЕ. Лазерная допплеровская флоуметрия в диагностике и выборе тактики лечения при повреждениях периферических нервов.
- В: Крупаткин АИ, Сидоров ВВ, ред. Лазерная допплеровская флоуметрия микроциркуляции крови. М.: Медицина; 2005. с. 136–48. (Krupatkin AI, Golubev VG, Panov DE. Laser Doppler flowmetry for diagnosis and treatment choice in peripheral nerves damage. In: Krupatkin AI, Sidorov VV, editors. Laser Doppler flowmetry of blood microcirculation. Moscow: Meditsina; 2005. p. 136–48.Russian).
- Fuller SC, Strong EB. Computer applications in facial plastic and reconstructive surgery. Curr Opin Otolaryngol Head Neck Surg.
- ;15(4):233–7.
- Kim YK, Park CS, Kim HK, Lew DH, Tark KC. Correlation between changes of medial rectus muscle section and enophthalmos in patients with medial orbital wall fracture. J Plast Reconstr Aesthet Surg. 2009;62(11):1379–83.
- Kolk A, Pautke C, Wiener E, Ploder O, Neff A. A novel high-resolution magnetic resonance imaging microscopy coil as an alternative to the multislice computed tomography in postoperative imaging of orbital fractures and computer-based volume measurement. J Oral Maxillofac Surg. 2005;63(4):492–8.
- Ploder O, Klug C, Voracek M, Backfrieder W, Tschabitscher M, Czerny C, Baumann A. A computer-based method for calculation of orbital floor fractures from coronal computed tomography scans. J Oral Maxillofac Surg. 2001;59(12):1437–42.
- Ploder O, Klug C, Backfrieder W, Voracek M, Czerny C, Tschabitscher M. 2D- and 3D-based measurements of orbital floor fractures from CT scans. J Craniomaxillofac Surg. 2002;30(3):153–9.
- Ploder O, Klug C, Voracek M, Burggasser G, Czerny C. Evaluation of computer-based area and volume measurement from coronal computed tomography scans in isolated blowout fractures of the orbital floor. J Oral Maxillofac Surg. 2002;60(11):1267–72.
- Regensburg NI, Kok PH, Zonneveld FW, Baldeschi L, Saeed P, Wiersinga WM, Mourits MP. A new and validated CT-based method for the calculation of orbital soft tissue volumes. Invest Ophthalmol Vis Sci. 2008;49(5):1758–62.
Supplementary files
