Yakubova Zulfiya

Title: Neurological aspects of preoperative preparation for children with mandibular deformities.

Abstract

The problem of preoperative preparation of children with congenital and acquired jaw defects and deformities remains relevant and poorly studied. The peculiarity of solving this problem lies, firstly, in the fact that, based on the multifactorial origin of the main disease, the forms of its manifestation are diverse. Secondly, partial or complete restriction of lower jaw movements, the inability to fully extend it forward, makes external respiration difficult due to dislocation asphyxia, which intensifies when the patient lies horizontally during sleep, leading to brain and overall body hypoxia. The above-mentioned disorders worsen the functional state of all parts of the nervous system. They lead to the exacerbation of original diseases of internal organs and systems, including neurological ones. In such cases, the neuro-hormonal-metabolic regulation system can be disrupted, which can serve as a reason for disruption of metabolism and the activity of internal organs, i.e., a group of diseases arises, which V.G. Vogralik  proposed to call "disregulatory visceropathies."

Study objective: to assess the health status of children with acquired defects and deformities of the maxillofacial region and to substantiate the tasks of a neurologist in preoperative preparation.

Materials and Methods: To achieve the set goal, we examined a total of 30 children with acquired defects and deformities of the maxillofacial region aged 3 to 16 years, requiring surgical treatment, during the period 2016-2024yy. Of these, 12 (40%) were boys and 18 (60%) were girls. Therefore, all patients were examined according to the program we proposed (Yakubov R.K.,1999), involving specialists from the Tashkent Medical Children's Consultative and Diagnostic Center. Preliminary comprehensive examination of patients before hospitalization contributed to the identification of internal organ pathologies against the background of connective tissue dysplasia, including the bone system..

Outcomes: The results obtained during somatoscopy showed: Jawbone deformities in 100% of patients, posture disorders, scoliosis - in 87% of patients, chest deformities - in 32%, limb X- and O-shaped deformities - in 15%, foot pathology (flatfoot, limping) - in 73%, joint hypermobility - in 15% of patients with signs of encephalopathy, convulsive alertness against the background of dysmetabolic syndrome. As a result of clinical, laboratory, and functional studies, we also identified signs of vegetative-vascular dystonia and asthenic-neurotic syndrome, visceral syndrome, arrhythmic syndrome, mental sphere disorders.

Conclusions: Thus, as a result of a comprehensive study, we were able to identify functional disorders of the CNS and VNS associated with both the main pathology and its consequences. This requires the mandatory participation of a neurologist in improving the special comprehensive examination program and conducting pharmacocorrection and physiotherapy in the preoperative period for all patients with identified disorders.