2025, volume 21

Objective: to determine the pathogenetic role of tissue expression of tumor necrosis factor a (TNF-a), interleukins (IL) 1(3 and IL-6 in the development of the clinical and morphologic diversity of chronic apical periodontitis. Material and methods. The study involved 94 patients with apical periodontitis. Clinical, radiographic, and morphological data were used. Lesion samples were taken during apicoectomy, and pulp tissues were taken from removed molars for cytokine analysis. Results. The levels of IL-1 b and IL-6 significantly differed between the symptomatic, asymptomatic, and control groups. IL-1 b in the symptomatic group was 22.03±3.21 pg/ml, in the asymptomatic group it was 14.17±3.34 pg/ml (p<0.001), there was no IL-6 in the control group. 26.38±5.09 pg/ml (symptomatic) versus 12.32±2.61 pg/ml (asymptomatic; p<0.001). TNF-a was detected in 23 cases of periodontitis without intergroup differences. In radicular cysts, IL-1 b is higher than in granulomas(p<0.001). Correlation of IL-1 band IL-6: Rs=0.32(p=0.043) and Rs=0.44 (p=0.026). Conclusion. The key role of IL-1 p and IL-6 in the development of clinical and morphological diversity of chronic apical periodontitis was confirmed. IL-1 (3 level >15 pg/mL distinguishes symptomatic from latent lesions, and its concentration >18 pg/mL in radicular cysts is a marker for the choice of treatment tactics. IL-6 correlates with bone resorption, justifying the use of its inhibitors in refractory forms. The results formed the basis of a protocol for periapical fluid testing for early stratification of patients to reduce the risk of unnecessary tooth extraction.

Objective: to evaluate the possibility of using the technology of step-by-step formation of the foveal intact fragment and the superior inverted fragment of the internal limiting membrane in surgery for traumatic macular hole of the retina. Material and methods. 7 patients (7 eyes) with traumatic macular hole as a result of severe contusion of the eyeball, including 5 with complicated traumatic macular hole, 2 with uncomplicated. Preoperative best corrected visual acuity (BCVA) ranged from 0.03 to 0.12, minimal macular hole diameter ranged from 230 to 512 urn. All patients were operated on using a modification of the surgical technique. The observation period is up to 1 year. Results. Closure of the traumatic macular hole occurred in all patients. In all treated patients, over a period of up to 3-6 months, there was a gradual increase in visual acuity (up to 0.5-0.7), the limitation of which in some cases (up to 0.05-0.2) was associated with the severity of the consequences of the contusion on the neuroreceptorthe apparatus of the eye and the combination of lesions. Conclusion. The proposed technology can be successfully used in surgery for traumatic macular hole, especially with combined contusion damage to the posterior pole of the eyeball, because it allows for surgical intervention without long-term postoperative tamponade of the vitreal cavity with gas or silicone oil.

Objective: to determine the effectiveness of rinsing the nasal cavity with a large volume of mineral-vegetable isotonic solution using an individual device in the postoperative period in patients with severe chronic rhi-nosinusitis with polyps and compare the results of the study with the effectiveness of copious instillation of the same solution into the nasal cavity. Material and methods. The study included 45 people aged 28-49 years after endoscopic pansinusotomy In the postoperative period, 2 groups were identified: in group 1 (n=33), the nasal cavity was rinsed using an individual device with a mineral-vegetable isotonic solution (recipe No. 1) with a volume of 240 ml and a temperature of 36 °C 2 times a day. In group 2 (n=12)— copious instillation of the same solution (20 ml in each half of the nose) was performed 4 times a day. The effectiveness of nasal breathing was evaluated according to the Visual Analog Scale and the Sino-Nasal Outcome Test 22 questionnaire and the degree of crust formation on days 5-6, 14. Results. In group 1, the effectiveness of nasal breathing was significantly higherthan in group 2 on days 5-6 and 14 of follow-up according to Visual Analog Scale (p=0.001 and p=0.04, respectively), the Sino-Nasal Outcome Test 22 (p=0.002 and p=0.004) and the condition of the nasal mucosa. Conclusion. Rinsing the nasal cavity with an individual device with a solution of the composition (recipe No. 1) is effective for improving nasal breathing in the postoperative period, reduces cortical formation, and normalizes healing. With heavy instillation, these indicators were worse.