Yurin О. Optimizing of the prevention and treatment of radiation injuries of paranasal reconstructed cavities

The aim of the thesis is to improve the efficiency of diagnosis and treatment of patients with primary malignant tumors of the maxillary sinus and ethmoid labyrinth using multidetector computed tomography, perfusiongraphy, oximetry, reconstructive plastic and systemic enzyme therapy. The thesis's findings are based on the results of diagnosis, treatment and monitoring of 98 patients (50 men and 48 women) with malignant tumors of the maxillary sinus and ethmoid labyrinth. Within the treatment algorithm "systemic enzyme + operation + radiotherapy" has been proposed and tested a new method of reconstructive prevention of radiation lesions at the surgical treatment of malignant tumors of the maxillary sinus and ethmoid bone by hiding postoperative cavity walls with eyelid skin graft. This improves healing and enhances radiotherapy interval at conducting postoperative radiotherapy. Pathogenetically substantiated prophylaxis method of inflammatory complications and irradiated tissue lesions with the use of polyenzyme drug vobenzim and cytochrome C has been developed and tested. The use of the developed surgical and pharmacological methods under the treatment algorithm "systemic enzyme + operation + radiotherapy" significantly reduces the severity of radiation damages: the rate of the 1st degree radiomucites constitutes 36.6%; the 2nd degree radiomucites is 56.3%; those of the 3rd degree is 37.1% and the 4th degree radiomucites have not been registered. While in the control the indexes are 14.8% , 40.8%, 33.8% and 11.1% respectively.