The determination of pain perceptance and conduction disturbance degree of the second branch of the trigeminal nerve in patients with bones fractures in the middle zone of the face during transcranial electrostimulation and Keltican N medication
DOI:
https://doi.org/10.11603/2311-9624.2019.2.10396Keywords:
bones fractures in the middle zone of the face, electrodiagnostics, the second branch of the trigeminal nerve, Keltikan N, to the method of transcranial electrostimulationAbstract
Summary. The treatment of midline fractures is one of the pressing problems of surgical dentistry and maxillofacial surgery [4]. This is due to the fact that the injuries of the bones of the middle area of the face in frequency occupy the second place among fractures of the maxillofacial area (thyroid) and reach 20–35 %, with a tendency to decrease their number is not observed.
The aim of the study – to optimize the diagnostic and therapeutic process in patients with fractures of the bones of the middle zone of the face at the stage of postoperative rehabilitation by introducing the method of electrodiagnostics of conduction disorders of the second branch of the trigeminal nerve, taking the drug «Keltikan N» and applying transcranial electrostimulation.
Materials and Methods. We conducted our evaluation of the electrical conductivity of 50 patients with fractures of the upper jaw, zygomatic bone body and arch, which treated using orthopedic methods. We proposed methods of diagnosis, physiotherapy and medication drug that improves the effectiveness of treatment in patients with middle zone face fractures. The state of electrical conductivity of the second branch of the trigeminal nerve was compared when receiving the drug «Keltikan N» and sessions of transcranial electrostimulation.
Results and Discussion. On the first day of hospitalization, all patients have a marked conduction violation of the second branch of the trigeminal nerve. At the end of treatment in the main group, a significant positive dynamics was observed in improving the electrical conductivity of the second branch of the trigeminal nerve, as indicated by the restoration of sensitivity threshold (ST), pain threshold (PT), and the pain endurance level (PEL) almost to the level of intact contholateral side. The results allow maxillofacial surgeons to use in clinical practice medicine «Keltikan N” and the method of transcranial electrostimulation.
Conclusions. Using the PulpTester DY310 electrodiagnostic, you can follow the process of restoring the conduction of the second branch of the trigeminal nerve by measuring the threshold of sensitivity and threshold of pain and pain perception according to the level of endurance to pain. With the combined use of the drug «Keltikan N» and transcranial electrostimulation, there is a significant improvement in the threshold of sensitivity and pain threshold of the second branch of the trigeminal nerve and increased pain relief; restoring electrical conductivity in the traumatically damaged branch of the trigeminal nerve is evidence of active repair processes in it. The use of the drug «Keltikan N» and transcranial electrostimulation are justified in the complex treatment of fractures of the bones of the middle area of the face, which are accompanied by damage to the second branch of the trigeminal nerve.
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