Objective. To study the effect of local photodynamic therapy (PDT) on local immunity in patients with maxillofacial region and neck phlegmonas.Materials and methods. The study included 62 patients with phlegmon of the maxillofacial region and neck. Two groups of patients were formed. Patients of the 1st group were treated locally according to the traditional methods. Patients of the second group additionally underwent local PDT on the background of the complex of traditional therapeutic measures.Results. Under the influence of local PDT with the preparation «Fotolon» in patients with maxillofacial region phlegmonomas in the postoperative wound we observed activation of phagocytosis, an increase in the population of CD3 + T-lymphocytes, subpopulation CD4 + T-helper, immunoregulatory index (IRI) with a simultaneous decrease in the level of CD8 + T-lymphocytes, The decrease of CD25+ activated Tand B-lymphocytes carrying the receptor for interleukin 2, and CD95+ activated Tand B-lymphocytes carrying the Fas-receptor, the decrease of complement activity, circulating immune complexes (CIC), IgM, IgA levels with an increase of IgG.Conclusion. Local PDT activates local immunity in patients with maxillofacial and neck phlegmons. Exposure to PDT causes a more balanced immune system response by increasing the innate immune response in patients and a pronounced immunological reactivity in the region of the postoperative wound.

Background. The problem of treatment of phlegmon of the maxillofacial region and neck remains one of the most urgent problems of maxillofacial surgery. Aim. To determine the degree of influence of local Low Level Laser Therapy (LLLT) on the quantitative and functional characteristics of immunocytes and humoral factors in peripheral blood and lavage fluid in phlegmon of the maxillofacial region and neck. Material and methods. We have examined and treated 60 patients with phlegmon of the maxillofacial region and neck. Of these, 30 people made up group 1 – traditional treatment and 30 people were included into group 2 (traditional treatment supplemented with local LLLT). Also, 12 practically healthy individuals were examined to determine the regional norm of the selected indicators (control group). The total number of leukocytes and their subpopulations were determined in the blood and lavage fluid, immunophenotyping of lymphocytes was performed using monoclonal antibodies (CD3+, CD4+, CD8+, CD16+, CD19+, CD25+, CD95+), determination of the phagocytic index (PhI) and phagocytic number (PhN), the study of hemolytic complement activity (CH50), the presence of circulating immune complexes (CIC) and the level of immunoglobulins (Ig) of classes M, A, G. Results. Weekly local exposure of LLLT contributed to a decrease in leukocytes and neutrophils in the blood with an increase in their functional activity (PhN), an increase in the number of lymphocytes, levels of IgM, IgG, while reducing CH50 in blood serum. In the lavage fluid under the influence of LLLT, a decrease in leukocytes, neutrophils, activation of phagocytosis, an increase in lymphocytes due to the number of CD3+ and CD4+ T-lymphocytes, a decrease in CD8+ of cytostatic T-lymphocytes, CD25+ activated T- and B-lymphocytes, CD95+T- and B-lymphocytes, decrease in CH50, IgM level and increase in IgG were revealed. Conclusion. Comprehensive treatment of patients with phlegmon of the maxillofacial region supplemented with LLLT has a modulating effect on cellular and humoral immunity factors by enhancing the local immune response.