Background — One of the main causes of hyperergic postoperative tissue response could be a prolonged opening in the septum between normally isolated anatomical regions, e.g., of the nasal cavity and oropharynx in patients with congenital disorders of maxillofacial region, which leads to anomalous exchange of their microbiotas. Objective — The objective of this study was to determine the composition of culturable facultative anaerobic microbiota of oronasopharyngeal mucosa, and to identify cytokine profiles in patients with congenital disorders of maxillofacial region in both preoperative and postoperative periods. Methods and Results — Our study is based on the results of examining the children with unilateral congenital cleft of upper lip (CL) before and after surgery, as well as examining the children with simultaneous unilateral congenital cleft of upper lip and palate (CLP) before and after primary rhinocheiloplasty. We used ELISA to determine the content of interleukin-10 (IL-1β) and interleukin-10 (IL-10) in the samples of blood serum and mucosal surfaces. The study of culturable microflora was conducted in patients before the surgery and during a postoperative period, specifically at one, three, six, and twelve months. Isolation of pure bacterial cultures was performed via conventional bacteriological methods followed by identification using MALDI-TOF testing. Before the surgery, microbial colonization was observed at significantly higher levels in CLP children than in healthy children. After the surgery, microbiological indicators partially came to normal values solely in CL patients. Local IL-1β concentrations remained significantly higher than those found in healthy subjects. In terms of postoperative dynamics, blood plasma antioxidant activity declined below normal values in CLP patients. Conclusion — Our study demonstrated the need for preoperative eradication of potential pathogens (e.g., Staphylococcus aureus, Klebsiella spp., Candida spp. and Streptococcus spp.), preferably, via using non-antibiotic approaches, such as probiotics and phage therapy, as well as supportive integrative therapy (e.g., using antioxidants).

In the article results of mediator regulation of inflammatory processes in patients after one-sided (15 children) and reconstructive (15 children) rinocheiloplasty are presented. It is determined that in patients after reconstructive rinocheiloplasty at 57th day post operation antioxidant capacity of blood plasma is below normal values, that points on lack of compensatory increasing of anti-radical ferments. Specified deficit is necessary to be considered in conservative treatment by applying antioxidants.

Congenital clefts of the maxillofacial area still remain of current interest in reconstructive facial surgery. While their frequency grows up, the issues of effective surgical primary and secondary interventions are not completely solved yet. The article presents the main problems associated with the elimination of the deformations and our modifications of methods for their correction. The study was conducted based on the Centre [2] and the University [1], Russian Federation. The project was carried out within the framework of the state assignment of the Ministry of Science and Higher Education of the Russian Federation, mnemocode 0669-2020-0008. The research is based on the results of complex treatment of 112 patients with unilateral clefts of the upper lip and palate from the age of 5 to 34 years, 68 patients of them also carried out secondary surgeries. The methods of performing rhinocheiloplasty by moving a “sliding” flap, of eliminating a ctenoid plica appearing after primary surgeries are presented, described, explained, and substantiated in the article. The proposed methods gave a good or satisfactory result in 92.8% of the operated patients, which allows them to be considered effective for eliminating congenital and postoperative nasal deformities in patients with facial clefts. : The surgical methods of eliminating congenital and postoperative deformities of the nose in patients with facial clefts should be modified in accordance with the nature of the most frequently arising shortcomings of the surgical stages of correction.