The dissertation research is devoted to increase of efficiency of diagnostic, treatment and prevention of development of complications at patients with various forms of odontogenic maxillary sinusitis (OMS).
We studied the most correctly and completely filled archival medical records of 206 patients with OMS who were hospitalized to the Department of Head and Neck Surgery «Kharkiv Regional Hospital», the clinical base of the Department of Oral and Maxillofacial Surgery of Kharkiv National Medical University in 2014-2017 which compared the retrospective group. According to the main clinical data (complaints, medical history and life, objective and local examination) and additional
research methods (radiological, microbiological, pathological and histological) we formed 5 main groups of patients with OMS according to the form of pathology and clinical manifestations: 1. Acute forms of OMS, with serous (group A) and purulent manifestations (group B). Exacerbation of chronic OMS, with catarrhal-polyposis (group C) and purulent-polyposis manifestations (group D). 3. Chronic forms of OMS (group E). After studying the statistics of medical records of the selected group of patients, we were found that the most common clinical form of this pathology - exacerbation of chronic catarrhal - polyposis sinusitis -147 clinical cases (71,3 %), identified the most common factors - various forms of periodontitis - 89 patients (43,2%), radicular cysts - 73 clinical cases (35,4%). Less common pathology was the acute form of OMS - 43 clinical cases (20,9%), with serous changes (27 patients) (13,1%). Chronic forms of OMS occurred in a minority of cases - 16 (7,7%).
In 91% of cases, the correctness of the tactics of comprehensive treatment of patients with OMS was confirmed by MES; It was found that in 9.2% of clinical cases, the choice of the amount of surgery did not correspond to the predicted using an automated computer program, which could be associated with complications. These results proved the effectiveness of the MES and led to further testing of a computer program in the treatment of a prospective group patients with OMS.
The results of treatment of 153 patients of the prospective group with the use of MES has been analyzed. Credible computer diagnoses were obtained, proposed by MES, which coincided with the final clinical ones in 97%, and individualized complex treatment was applied to each of the clinical cases. With the use of MES, to predict the diagnosis and the option of a comprehensive individual treatment option, it was possible to reduce the proportion of actual complications depending on the clinical form of OMS from 9.2% (19 patients) to 2.6% (4 patients).
