The results of rehabilitation of patients with phlegmonparotid-masticatory region, depending on the severity of surgical intervention
Background. Despite the high occurrence (60%) of postoperative complications in patients with phlegmon parotid-masticatory region is not developed rehabilitation depending on the severity of surgery on the masticatory muscle. Aim. To improve the diagnosis and treatment of the effects of surgical intervention on masticatory muscle about phlegmon parotid-masticatory region via the study of some pathogenetic features of the formation of myofascial pain syndrome by a method of neurophysiological diagnosis and quality of life based on questionnaire SF-36. Material and methods. Neurophysiological study and quality assessment (SF-36) life by 36 patients with a history of surgery regarding phlegmon parotid-masticatory areas, which were divided into three subgroups depending on the severity of surgical intervention and appropriate degree of myofascial dysfunction of the muscles of mastication (MM) arising in the postoperative period. The results and discussion. Patients side myofascially MM dysfunction due to surgery, the amplitude of biopotentials in fact MM was reduced, the expression in groups with more traumatic surgery, on the opposite side only in patients with a severe degree of dysfunction. As a result of treatment electromyography revealed a recovery in the amplitude of biopotentials MM mild her dysfunction and her approach to the parameters of normal with moderate and severe dysfunction. In patients with postoperative myofascial dysfunction of MM has declined physical and psychological components of health. Despite the severity of surgical treatment no statistically significant differences in the indicators of health scales in compared groups. A month after the end of rehabilitation stage of treatment was noted positive dynamics of indicators of quality of life in patients with phlegmon parotid-masticatory region. When intra-group comparison of the quality of life group was significantly observed more pronounced dynamics in patients with mild, less medium and less severe - with severe myofascial dysfunction of the MM. Conclusions. Clinical and neurophysiological characteristics of the postoperative dysfunction of the chewing muscles allows to distinguish three degrees of severity of myofascial pain syndrome associated with the severity of the surgery. At the rehabilitation stage of treatment is the adaptation of the masticatory muscles to the new conditions of functioning, manifested in its increase of the amplitude of the potentials inherent in each of the degree of myofascial dysfunction. The use of the SF-36 questionnaire revealed a deterioration of the quality of life in patients in the postoperative period with phlegmon parotid-masticatory region in comparison with a healthy population. Positive dynamics of indicators of quality of life in patients with phlegmon parotid-masticatory region testifies to the effectiveness of the rehabilitation phase of treatment.