COMPUTER MODELING AND LASER TECHNOLOGIES IN REHABILITATION OF PATIENTS WITH MIDFACIAL TRAUMA

Aim: To assess the kind of damage of musculoskeletal apparatus of eye and orbit. To develop algorithm of laser therapy to restore orbital circulation and algorithm of transcranial laser therapy to improve microcirculation in maxillofacial muscles. Materials and methods: 75 patients with midfacial trauma were examined using laser spectrophotometry and computer modeling of orbital structures in frontal, sagittal, and inclined planes with SSD, MPR and VRT reconstructions (with Mimics software (Materialise, Leuven, Belgium)). To study orbital and maxillofacial microcirculation complex Spectrotest was used. Tissue oxygen concentration (SatO2) and blood filling volume index of microcirculation (Vbf) were measured. Results: After computer modeling, several variants of damage of musculoskeletal apparatus of eye and orbit were identified including oculomotor muscle entrapment in 60% of patients, angular deviation of muscle belly in 30%, muscle contusion – in 45%, orbital hematoma – in 18%, scarring of musculoskeletal apparatus of orbit – in 40%. During early period of trauma of orbital wall and maxillary sinus, Vbf decreased by a mean of 12.5 ± 0.5% compared to normal values, whereas contralateral microcirculation increased by a mean of 28.5 ± 0.1% compared to normal values. Abnormal blood distribution persisted in the long-term, after bone reposition: blood flow increase was found only in 10% of patients. In severe trauma and chronic scarring, local laser irradiation was associated with increase of Vbf bilaterally, but chronically and significantly increased SatO2 indicated impaired tissue trophics and high risk of inflammatory complications. Conclusion: Computer modeling is of great value in the diagnosis and rehabilitation planning in patients with injuries of musculoskeletal apparatus of eye and orbital structures. Laser spectrophotometry is useful for the monitoring of microcirculation before, after the operation and during rehabilitation.