Laura Neimane, Liene Zamure, Vadims Klimecs, Aleksandrs Grišuļonoks, Andrejs Skaģers and Andrejs Ivanovs
Sinus lift surgery elevation is a procedure that requires radiological maxillary sinus evaluation and procedure planning. The condition of the maxillary sinus before and after sinus lift surgery was assessed. Sixty-five sinuses of 49 patients were included in the study. Preoperative and postoperative cone beam computed tomography (CBCT) scans were performed. The sinuses were analysed radiologically for pathological changes: mucosal thickening, ostia obstruction and accessory opening. The presence of concha bullosa in nasal cavity and septa in the maxillary sinus were recorded. The sinus volume also was measured before and after surgery. Thickened mucosa was found more often in postoperative scans than in preoperative scans (63.1% and 67.7%, respectively). Concha bullosa was found in 30 preoperative scans and in 33 postoperative scans. A correlation between mucosal thickening and ostia obstruction was found. The mean sinus volume decreased after surgery and the changes were statistically significant. In conclusion, changes of the maxillarysinus and nasal cavity can be detected with CBCT. Sinus lift surgery does not excacerebate the existing conditions of the maxillary sinus; however, there is a tendency for pathological features to increase after surgery. Sinus lift surgery is a safe surgery with regard to the maxillary sinus if performed with care.
Kalvis Pastars, Jānis Zariņš, Juris Tārs, Anna Ivanova and Andrejs Skaģers
Radial forearm flap is a gold standard for oral soft tissue defect reconstruction after tumour ablative surgery of oral cancer in advanced stages. The main disadvantage of this flap is donor site morbidity. The goal of our study was to show versatility of lateral arm flap in 34 cases with different oral defects that were reconstructed after tumour ablation, and to analyse complications and donor site morbidity. Thirty-four patients with advanced stage oral cancer (T3 and T4) underwent tumour ablation with or without suspicious lymph node removal and with immediate reconstruction of oral defect with lateral arm flap. Analysis of complications and donor sites morbidity was carried out. The Michigan Hand Outcome Questionnaire was used to evaluate functional and esthetical donor site outcome during at least one year follow up. Thirty-one patients had successful free flap surgery with uneventful post-surgery period. Flap loss due to vascularity problems was in one case (2.9%). The flap success rate was 97.1%. The donor site was closed primarily in all cases and healed uneventfully. The Michigan Hand Outcome Score was average 94.30%. The lateral arm is an excellent choice for oral reconstruction after ablative tumour surgery. It is versatile, safe and reliable for oral reconstruction with very good functional and aesthetical donor site outcome.
Vladislavs Ananjevs, Aleksandra Ananjeva, Jānis Vētra, Andrejs Skaģers, Ilze Salma, Laura Neimane and Vladimir Kasyanov
Bone density of the femur body of rabbit was determined in vivo. Experimental osteoporosis was induced by ovariectomy and subsequent injections of methylprednisolone. In the greater trochanter region of right femur, defects were created and filled with granules of hydroxyapatite and tricalcium phosphate (HAP/TCP 70/30) or HAP/TCP 70/30 together with 5% strontium. After three months, the animals were euthanized. The bone mass density of the right and left body of femur was measured by cone beam computed tomography (CT) scan. The results of the study showed that the right femur of the rabbit, where biomaterials had been implanted, and the left femur, where no biomaterial implantation occurred, became denser after filling the defect with HAP/TCP 70/30 ceramic granules or 5% Sr modified HAP/TCP ceramic granules. There was no difference between operated and non-operated legs and HAP/TCP and HAP/TCP with 5% strontium groups.