ULTRASOUND STUDY OF PATIENTS WITH KELOID SCARS OF THE MAXILLOFACIAL AREA

D. Avetikov, O. P. Bukhanchenko, V. V. Aipert, K. Lokes
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Abstract

Despite the possibility of modern surgery and dermatological cosmetology, the problem of differential diagnosis of patients with keloid scars remains relevant and significant at present. As clinical practice shows, not just the presents and the size of functional or aesthetic defect in scar tissue changes are important, but also the degree of their negative influence on the process of physical, psychological and social adaptation of the patient. The aim of our study was to optimize and improve the effectiveness of treatment of facial keloid scarring by identifying the type of scarred skin of the head and neck, and using ultrasound examination. The ultrasound method of investigation was performed on 50 patients with keloid scars of the head and neck. Clinical study of the general characteristics of the scar was supplemented by an additional analysis of the structural features of the cicatricial tissues by ultrasound examination. For the purpose of comparison, intact skin was used. Analysis of ultrasonography allowed to determine the color echogenic pattern of keloid scars, which differed substantially from the dermis of intact skin. Among the echogenic signs of postoperative keloid scarring, one should point out an increase in the depth of cicatrix of the tissue in comparison with the thickness of the intact derma, an average of 8-11%, an average thickness of the epidermis is 18-26%, a clear boundary between intact skin and keloid scar is traced, which is a clear differential sign of this type of scar. Only in 7% of cases, we have visualized the border with the hypodermis in the peripheral edges of the scar, which indicates the infiltration character of the growth of the keloid and again proves its similarity with the tumor. Today, there is no universal method for differential diagnosis of various types of scars of the head and neck. Therefore, it is necessary to develop an informative and economically expedient method of diagnostics. Ultrasonography of scarring is a non-invasive survey method that can objectively, informatively and safely evaluate numerous anatomical structures, determine the type and depth of scar formation.
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颌面部瘢痕疙瘩患者的超声研究
尽管现代外科手术和皮肤美容成为可能,但瘢痕疙瘩患者的鉴别诊断问题仍然具有重要意义。临床实践表明,瘢痕组织变化中功能或美学缺陷的形态和大小不仅重要,而且对患者生理、心理和社会适应过程的负面影响程度也很重要。我们的研究目的是通过识别头颈部疤痕皮肤的类型,并利用超声检查来优化和提高面部瘢痕疙瘩的治疗效果。本文对50例头颈部瘢痕疙瘩进行了超声检查。通过超声检查对瘢痕组织的结构特征进行分析,补充了对瘢痕一般特征的临床研究。为了比较,我们使用了完整的皮肤。超声分析允许确定瘢痕疙瘩疤痕的颜色回声模式,它与完整皮肤的真皮层有很大的不同。在术后瘢痕形成的回声征象中,需要指出的是,与完整真皮厚度相比,组织瘢痕深度增加,平均为8-11%,表皮厚度平均为18-26%,完整皮肤与瘢痕形成清晰的界限,这是该类型瘢痕的明确鉴别征象。只有7%的病例,我们在瘢痕的外周边缘看到了与皮下组织的边界,这表明瘢痕疙瘩的生长具有浸润性,再次证明了它与肿瘤的相似性。今天,没有一个通用的方法来鉴别诊断各种类型的头颈部疤痕。因此,有必要开发一种信息丰富、经济方便的诊断方法。疤痕超声检查是一种无创的调查方法,可以客观、信息、安全的评估众多解剖结构,确定疤痕形成的类型和深度。
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审稿时长
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