Grygorov S. Pathogenetic mechanisms, diagnostics and prevention of complicated course of injuries of facial cranium.

By means of methods of evidence-based medicine and considering conceptually new approach to the definition of integrative mechanisms of formation and development of complicated course of injuries of facial cranium, on the basis of risk assessment and taking into consideration general health state, prevention and early diagnostics of complicated course of injuries of facial cranium, in the thesis there were identified ways for increasing the effectiveness of complex treatment and developed multi-stage system of clinical monitoring. The features of common vascular - reflex reactions and regulation of cerebral blood flow in patients with injuries of facial cranium were investigated. It was proved that by injuries of facial cranium pathogenetic correction of vascular-reflex reactions should be aimed at eliminating of vase- and anhiopressor manifestations of central origin, because in patients with complicated course of injuries of facial cranium it was revealed that in preoperative phase there is growth in intensity and forming of asymmetry of brain blood supply by reducing the elasticity of small vessels and increasing the tone of arteries and arterioles while reducing the compliance of the vascular wall to dilatation. Pathogenetic role of cerebral blood flow autoregulation disorders in the development of complicated course of injuries of facial cranium in case of combined trauma and concussion of the brain was proved. It is proved that the original structure-functional state of bone tissue and metabolic supply of bone remodeling - is a determinative factor for development of complicated course. It was revealed that patients with complicated course of injuries of facial cranium more frequently have osteopenic disorders, and depth of these violations is more expressed. Therefore, in order to improve diagnostics of osteopenic disorders in patients with injuries of facial cranium, the procedure for assessment of bone mass by its somatomet-ric gradient is grounded, and it takes into account not only the structure - functional state of bone tissue and bone mass, but also individual somatometric patients' characteristics. The multistage systematic complex of innova-tive support of clinical monito-ring of complicated course of injuries of facial cranium is grounded in conditions of specialized department of oral and maxillofacial surgery.