Sonography of Emergency Conditions of the Maxillofacial Area

Abstract

Purpose. Echographic imaging efficiency evaluation in detection of urgent conditions in maxillofacial area (MFA). Materials and methods. Echographic examination was performed on a total number of 169 patients (age 18 to 70) with suspected various urgent conditions with MFA soft tissue pathology. Examination was carried out using the iU-22 ultrasound system (Philips, Germany), with the L 15-17 io (dedicated compact pen-transducer with 15 to 7 MHz operating frequency range) and the L 9-3 linear array transducers. B-mode and color Doppler flow mapping were applied. Results. 35 (20.7%) patients were diagnosed with sialolithiasis, 32 (18.9%) of them had “salivary colic”. 3 (1.8%) patients had acute sialolithiasis complication in the form of abscessing gland. Acute major salivary gland sialadenitis was found in 35 (20.7%) cases, of which 20 (11.8%) had serous inflammation and 15 (8.9%) - the purulent one. 39 (23.0%) patients were diagnosed with acute lymphadenitis, 20 (11.8%) of them had serous inflammation, 11 (6.5%) were in periadenitis stage, 8 (4.7%) had lymph node abscess. Acute extraorganal MFA soft tissue inflammation (n = 32 (18.9%): abscess was found in 25 (14.8%) cases, phlegmon - in 7 (4.1%) cases. Lateral (n = 16 (9.4%) and median (n = 9 (5.3%) cyst festering was identified. 3 (1.7%) patients had MFA soft tissue foreign body. Primary diagnostics and dynamic observation were performed in 100% cases. All results had clinical confirmation. B-mode echography allowed for the affected area characterization, location, size, pathological process depth of occurrence and expansion, surrounding structures condition. Duplex scanning allowed for vascularization evaluation. Conclusion. Echography is a highly-informative method of urgent conditions detection for patients with MFA diseases, usage of which on early stages of examination influences further treatment tactics.