Diagnosis and treatment criteria of craniofacial deformities in children: Summary of the doctoral thesis in medical sciences: 323.01- Stomatology

Abstract

Thesis structure: Introduction, 5 chapters, literature review, materials and methods, 3 original chapters, discussions, general conclusions, and recommendations, and bibliography of 221 titles, 2 appendices, 190 pages of basic text, 53 figures, 43 tables. The obtained results are published in 52 scientific papers. Keywords: pediatric craniofacial surgery, cranial suture, craniosynostosis, nonsyndromic craniosynostosis, metopic craniosynostosis, unicoronal synostosis, cranial vault remodeling. The aim of the study was the early surgical remodeling of the craniofacial parameters responsible for the pathology of the craniofacial massif, with the application of the reconstructive approach to reduce the potential action of the causal factors; improving the child's health and aesthetic appearance. In this context, we formulated the objectives: analysis of the incidence of craniofacial anomalies in children born in the Republic of Moldova, using standardized anthropometric and cephalometric data (in a mixed population - urban and rural); evaluation of craniofacial changes, syndromic and non-syndromic, in children by anthropometric and cephalometric methods; the neurophysiological characteristic of the functional motor activity of the sucking reflex of the child with craniofacial deformities preoperatively and postoperatively; the therapeutic approach to craniofacial dysmorphism through treatment with special headphones in different forms of clinical manifestation; synthesis of the criteria for surgical treatment and postoperative recovery of craniofacial deformities according to their type and the age of the child, with the elucidation of the criteria for the prophylaxis of secondary complications; estimating the management strategy of children with craniofacial deformities, surgical and postoperative reconstructive approaches, developing effective recovery criteria. Novelty and scientific originality. The study represents the first attempt at complex, comprehensive research at the national level of craniofacial dysmorphism in children from the Republic of Moldova, followed by the improvement of the life quality in the postoperative period. We pursued this aspect by analyzing the differentiation of neurophysiological and imaging markers of the bone, muscle, and nervous system in children. The important scientific problem. It deepens the knowledge of specialists of different profiles regarding the onset and type of craniosynostosis in children of different ages. Highlighting the neurophysiological variability of the bone-muscle-nerve complex function leads to the highlighting of cerebral and facial asymmetry, early diagnosis, differentiation, and early application. Theoretical significance. The study of the facial asymmetry of the cranial box, quantitative and qualitative, in relation to the deterioration of the sucking reflex, and neurophysiological and imaging changes, can influence the curative and rehabilitation conduct postoperatively. The applied value of the works. The research results, conclusions, and practical recommendations served to determine the diagnostic and treatment algorithm of craniofacial deformities concerning the facial asymmetry degree of the craniofacial, neurophysiological, imaging, and clinical parameters, especially with the impairment degree of the sucking reflex. Implementation of the results. The obtained results in the scientific study implemented in the Mother and Child Institute; Clinic Valentin Ignatenco; and in the IP USMF Nicolae Testemitanu, 6 invention patents, 1 innovator's certificate, and 5 results implementation documents were registered.