The study is aimed at demonstrating the usefulness of the rehabilitation program after extensive surgeries in patients with maxillofacial area (MFA) and neck tumors. Data from patients who underwent surgery in the clinics of the Republican Oncological Research Center and the Tashkent Institute of Postgraduate Medical Education for MFA and neck tumors were retrospectively analyzed. The patients were enrolled to the rehabilitation program, which consisted of a threestaged technique involving a complex prosthesis, and several physical therapies for damaged functions, such as chewing, swallowing and breathing. A total of 107 oncological patients with postsurgical defects were fitted with various types of prosthesis. The introduction of the rehabilitation program was performed at an interval between initial surgery and prosthesis formation of 10-15 days, and between initial surgery and preparation of the final prosthesis of 26–30 days. A restoration of the Karnofsky performance status to 80–85 % was observed. The present study demonstrates that the proposed rehabilitation program is useful for shortening the postoperative con-valescent period and improving the quality of life of patients with defects of the MFA and neck.
Муаллифлар жарроҳлик операцияларидан кейин юз-жағ соҳасидаги нуқсонларни реабилитация қилиш самарадорлигини ўрганиб, нуқсонни бартараф этиш учун мураккаб эндо- ва экзоортопедик протезлардан фойдаланган. Жарроҳлик амалиётидан сўнг юз-жағ соҳасида хавфли ўсмалари бўлган беморларни реабилитация қилиш жараёнида комплекс протезлаш усули ишлаб чиқилган ва жорий қилинган. Юз-жағ соҳасида нуқсонлари бўлган 107 нафар саратон касаллиги билан оғриган беморларнинг касаллик тарихи ва амбулатор карталари таҳлил қилинди, уларда протезлашнинг турли усуллари қўлланилди. Тадқиқот натижаларига кўра, полиуретан пластмассадан фойдаланган ҳолда, юз-жағ соҳасида нуқсонларни комплекс протезлаштириш методикаси яхшиланди, бу эса жарроҳлик кунида ҳимоя пластиналарини ишлаб чиқиш имконини берди. Кенг қамровли реабилитациядан сўнг хавфли ўсмалар ва юз-жағ соҳасида нуқсонлари бўлган беморлар доктор Карновскийнинг ўлчови бўйича 80-85 %гача соғайди.
Авторами изучена эффективность восстановительного лечения дефектов челюстно-лицевой области после хирургических вмешательств с использованием сложных эндо- и экзоортопедических протезов для устранения дефектов. В процессе реабилитации больных со злокачественными новообразованиями челюстно-лицевой области после хирургического вмешательства разработан и внедрен комплексный метод протезирования. Проанализированы истории болезни и амбулаторные карты 107 онкологических больных с дефектами лица и челюсти, в них использованы различные методы протезирования. По результатам исследования усовершенствована методика комплексного протезирования дефектов лица и челюсти с использованием полиуретановой пластмассы, что позволяет изготовлять защитные пластины в день операции. Пациенты со злокачественными опухолями и поражениями лица и челюстно-лицевой области выздоравливают после обширной реабилитации на 80-85 % по шкале доктора Карновского.
The study is aimed at demonstrating the usefulness of the rehabilitation program after extensive surgeries in patients with maxillofacial area (MFA) and neck tumors. Data from patients who underwent surgery in the clinics of the Republican Oncological Research Center and the Tashkent Institute of Postgraduate Medical Education for MFA and neck tumors were retrospectively analyzed. The patients were enrolled to the rehabilitation program, which consisted of a threestaged technique involving a complex prosthesis, and several physical therapies for damaged functions, such as chewing, swallowing and breathing. A total of 107 oncological patients with postsurgical defects were fitted with various types of prosthesis. The introduction of the rehabilitation program was performed at an interval between initial surgery and prosthesis formation of 10-15 days, and between initial surgery and preparation of the final prosthesis of 26–30 days. A restoration of the Karnofsky performance status to 80–85 % was observed. The present study demonstrates that the proposed rehabilitation program is useful for shortening the postoperative con-valescent period and improving the quality of life of patients with defects of the MFA and neck.
| № | Имя автора | Должность | Наименование организации |
|---|---|---|---|
| 1 | Ubaydullayev X.A. | tibbiyot fanlari nomzodi, “Onkologiya va stomatologiya” kafedrasining ilmiy xodimi | Rossiya va O'zbekiston Respublikasi onkologlari va stomatologlari uyushmasi a'zosi |
| 2 | Gafforov S.A. | tibbiyot fanlari doktori, professor | “Stomatologiya, bolalar stomatologiyasi va ortodontikasi” kafedrasi mudiri |
| 3 | Gafur Oxunov M.A. | tibbiyot fanlari doktori, professor, “Onkologiya” kafedrasi mudiri | Toshkent vrachlar malakasini oshirish instituti, Respublika ixtisoslashtirilgan onkologiya va radiologiya ilmiy-amaliy tibbiyot markazi |
| № | Название ссылки |
|---|---|
| 1 | Yuhan B.T, Svider P.F, Mutchnick S., Sheyn A. Benign and malignant oral lesions in children and adolescents: an organized approach to diagnosis and management. Pediatr Clin North Am, 2018, pp. 1033-1050. |
| 2 | Cervenka B., Pipkorn P., Fagan J., Zafereo M., Aswani J., Macharia C., Kundiona I., Nashamba V., Zender C., Moore M. Oral cavity cancer management guidelines for low-resource regions. Head Neck, 2019, no. 41, pp. 799-812. |
| 3 | Kaprin A.D., Aleksandrova L.M., Starinskii V.V., Mamontov A.S. Technologies for early diagnosis and screening in the early detection of malignant neoplasms. Onkologiya. Zhurnal im. P.A. Gertsena. 2018. no. 7(1), pp. 34-40, (In Russ.). |
| 4 | Semiglazova T.Yu., Tkachenko G.A., Chulkova A. Psychological aspects of oncological patients’ treatment. Zlokachestvennie opukholi, 2016, no. 4 (Suppl.1), pp. 54-58. (In Russ.). |
| 5 | Zenga J., Pipkorn P., Adkins D.R., Thorstad W.L., Nussenbaum B. Trials in head and neck oncology: Evolution of perioperative adju-vant therapy. Oral Oncol, 2017, no. 72. pp. 80-89. |
| 6 | Vural E. Surgical reconstruction in patients with cancer of the head and neck. Curr Oncol Rep. 2004, no 6, pp. 133-140. |
| 7 | Yang W., Zhao S., Liu F., Sun M. Health-related quality of life after mandibular resection for oral cancer: reconstruction with free fi bula fl ap. Med Oral Patol Oral Cir Bucal, 2014, no 19, pp. 414-418. |
| 8 | Mantri S.S., Khan Z., Agulnil M. Head and neck cancer. Prostodontic rehabilitation of acquired maxillofacial defects. Croatia: Intech, 2012, pp. 317-322. |
| 9 | Ferretti C., Reyneke J.P. Genioplasty. Atlas of the Oral and Maxillofacial Surgery Clinics of North America. St. Louis: Elsevier, 2016. |
| 10 | Triaca A., Brusco D., Guijarro-Martinez R. Chin wing osteotomy for the correction of hyper-divergent skeletal class III deformity: technical modification. Br J Oral Maxillofacial Surgery, 2015, vol. 53(8), pp. 775-777. |
| 11 | Pouzoulet P., Cheynet F, Guyot L, Foletti JM, Chossengros C, Cresseaux P. Chin wing: Technical note. J Stomatology, Oral Maxillofacial Surgery, 2018, vol. 119(4), pp. 315-318. |
| 12 | Van Gijn D.R., D’Souza J., King W., Bater M. Free flap head and neck reconstruction with an emphasis on postoperative care. Facial Plast Surg, 2018, no 34, pp. 597-604. |
| 13 | De Martel C, Ferlay J, Franceschi S. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. The Lancet Oncology, 2012, Т. 13, pp. 607-615. |
| 14 | Boyes-Varley J.G., Howes D.G., Davidge-Pitts K.D. et al. A new protocol for maxillary reconstruction following gunshot and oncology resection using zygomatic implants. Int. J. Prosthodont, 2007, vol. 20, pp. 521-531. |
| 15 | Ivashkina M.G. The experience of psychocorrection and psychorehabilitation accompaniment for person with cancer. Lechebnoe delo, 2010, no 3, pp. 49-54. (In Russ.). |
| 16 | Chau A.M.T., Mobbs R.J. Bone graft substitutes in anterior cervical discectomy and fusion. Europ. Spine J., 2009, vol. 18, pp. 49-64. |
| 17 | Arun P.S., Kaneesh K. A., Chacko R., Karunya W. Audit on titanium reconstruction of mandibular defects for jaw lesions. J. Pharm Bioallied Sci., 2014, 6 (Suppl 1), pp. 39-44. |
| 18 | Clark J.R. Predictors of morbidity following free flap reconstruction for cancer of the head and neck / J.R. Clark, S.A. McCluskey, F Hall [et.al]. Head Neck, 2007, vol. 29, no 12, pp. 1090- 1101. |
| 19 | Kim A.J. Salvage surgery with free flap reconstruction: factors aff ecting outcome after treatment of recurrent head and neck squamous carcinoma. A.J. Kim, J.D. Suh, J.A. Sercarz [et al.], Laryngoscope, 2007, vol. 11, no 6., pp. 1019-1023. |
| 20 | Bell R.B. Oral, Head and Neck Oncology and Reconstructive Surgery R. Bryan Bell. Rui P. Fernandes. Peter E. Andersen, 2018, Elsevier, Inc, pp. 2. |
| 21 | Dingman C.A., Hegedus P.D., Likes C. et al. Coordinated multidisciplinary approach to caring for the patients will head and neck cancer. J. Supp. Oncol, 2008, vol. 6, № 3, pp. 125-131. |
| 22 | Kaveh K., Ibrahim R., Bakar M.Z.A., Ibrahim T.A. Bone grafting and bone graft substitutes. J.Anim.Vet.Edv, 2010, vol. 9, pp. 1055-1067. |
| 23 | Salvatori P., Motto E., Paradisi S., Zani A., Podrecca S, Molinari R. Oromandibular reconstruction using titanium plate and pectoralis major myocutaneous flap. Acta Otorhinolaryngol Ital., 2007, pp. 227-232. |
| 24 | Barnes L. Adapted from World Health Organization Classifi cation of Tumours, Pathology and Genetics Head and Neck Tumours (edited by Adel K. El-Naggar, John K.C. Chan, Jennifer R. Grandis, Takashi Takata, Pieter J. Slootweg, IARC Press, Lyon, 2017), 159 р. |