Objective – To improve the results of surgical treatment of various defects of the auricle by improving the methods of otoplasty.
Material and Methods - The study included patients with acquired traumatic defects and III degree inborn folded auricle. The work was carried out in the Department of Plastic and Reconstructive Microsurgery of the State Institution " RSSPMCS named after Academician V. Vakhidov" for the period from 1990 to 2020. In general, the comparative analysis of the results included 38 patients in the main group, among them in 13 (34.2%) cases there were defects with extension to the central part of the auricle, 15 (39.5%) patients with III degree deformity of the auricle (folded auricle), as well as in 9 cases - marginal defects of the auricle and in 1 case a patient with a total traumatic defect. The comparison group included 28 patients, 16 (57.1%) - defects with extension to the central part of the auricle and 12 (42.9%) patients with III degree deformity of the auricle. Accordingly, the effectiveness of the proposed otoplasty method for ear defects was assessed according to two categories of pathologies - defects with extension to the central part of the auricle and grade III ear deformity (folded auricle). The average age in the main group was 22.4 ± 1.3 years, in the comparison group 19.4 ± 1.9 years.
Results - Improved methods of reconstruction of an amputated but preserved auricle, with a peripheral defect of the auricle, with a folded auricle, and reconstructive otoplasty with defects with the capture of the central parts of the auricle are proposed. In total, complications developed in 8 (29.6%) patients in the comparison group and 2 (7.1%) in the main group. At the same time, the incidence of surgical complications, which subsequently led to the need for re-reconstruction, was 11.1% in the comparison group. There were no complications in the main group. In total, 6 (22.2%) additional stages of otoplasty were performed in the comparison group. In the main group, an additional stage of surgery was required only in 1 (3.6%) case of the formation of an unnatural skin fold. There was also a statistically significant difference in the number of additional plastic surgery stages performed for the complications noted above (criterion χ2 = 4.305; df = 1; p = 0.039). The average duration of surgery in the comparison group for all stages of reconstructive otoplasty was 220.7 ± 2.7 minutes, and in the main group after 2-stage otoplasty according to the proposed method - 189.5 ± 1.9 minutes (t-criterion = -9 , 60; p <0.05).
Conclusion - The improved method of otoplasty in case of grade III defects or deformities of the auricle made it possible to reduce the overall incidence of complications from 29.6% to 7.1%, and to reduce the need for repeated reconstructive interventions from 22.2% to 3.6%, which, in general, led to a decrease in the period of complete rehabilitation from 4.4 ± 0.1 to 3.7 ± 0.1 months.
Medical rehabilitation of patients with defects, deformities of the jaws is an urgent problem in reconstructive maxillofacial surgery. Such defects cause significant dysfunctions of the organs of the maxillofacial region, disfigurement of the soft tissues of the lower face zone. A complex problem of maxillofacial surgery is the development of methods for surgical restoration of the integrity of organs and their function. Currently, various surgical methods and materials are used to restore the defect in the jaw bone tissue [12].
Evaluate the prevalence of congenital foot deformities in Brazil, as well as their epidemiological profile during the period of 2012 to 2022 and their impacts. This is a research conducted through secondary data analysis and cross-sectional typology in the databases of the Ministry of Health - Health Information (TABNET), made available by the Department of Informatics of the Unified Health System (DATASUS). Descriptors in health sciences: "deformidade do pé" and "foot deformities". A total of 55,472 cases of congenital foot deformities were registered in Brazil. The Southeast region had the highest prevalence with 43.1% of the cases. 57.3% of the cases were diagnosed by the age of 10 years old. The epidemiological profile of congenital foot deformities reveals risk factors to which a certain population is exposed, such as teratogenic agents.
Sharp predominance of defects in treatment and diagnostics is marked in medical practice of pediatrics. Among the defects of diagnostics inadequate diagnoses of the basic disease (trauma) and its complications predominate. Defects of treatment are revealed as mistakes in administration and carrying out medical procedures, defects of medication
Anomalies of the upper jaw are very common. According to various authors (1, 5), their prevalence in adults ranges from 28.8 to 37%. As for dental deformities, they are even more common, especially in patients with occlusal abnormalities complicated by dentition defects. According to a number of studies (2), such deformities occur in 67.1-69.4% of patients with partial tooth loss. Various methods of preparation for prosthetics are described in the dental literature (3, 4, 6). However, many problems remain unresolved.