Introduction. At present, objective difficulties remain in the timely diagnosis and treatment of severe complications of acute odontogenic infection, including progressive odontogenic phlegmon, contact odontogenic mediastinitis, odontogenic sepsis. Goal. Develop an algorithm for diagnosis and treatment of severe inflammatory complications of acute odontogenic infection, taking into account the criteria of “Sepsis-3” and evaluate its effectiveness. Material and methods. To conduct a comparative evaluation of the results of the study, patients (311 people) were divided into 2 groups: a control group (247 people), in which diagnosis and treatment were performed using the criteria “Sepsis-1”, and the main group (64 people), diagnosis and treatment were performed with using the developed algorithm for diagnosis and treatment, which includes a number of additions to the criteria of “Sepsis-3” of the European Society of Critical States Medicine and the Society of Critical States Medicine (SCCM / ESICM). Results. Using the developed algorithm for diagnosis and treatment of patients with odontogenic inflammatory diseases of the maxillofacial area allows to significantly increase the efficiency of early diagnosis of purulent-inflammatory processes in the maxillofacial region (by 5.7%), to reduce the number of severe septic complications (by 6.6%). Discussion. The application of the criteria “Sepsis-3” is not an effective method of early diagnosis of odontogenic sepsis. The conclusion. The conducted study confirmed the effectiveness of the developed algorithm for diagnosis and treatment of severe inflammatory complications of acute odontogenic infection, taking into account the criteria of “Sepsis-3”.

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Introduction. In the diagnosis and subsequent treatment of patients with phlegmons of the maxillofacial region and neck, a large number of errors are allowed, which leads to the growth of neglected extensive purulent processes. Goal. Increasing the effectiveness of diagnosis of acute odontogenic inflammatory diseases. Material and methods. The first block of research. To determine the relationship between the number of cell spaces involved in the odontogenic inflammatory process, the depth of lesion and the presence of organ failure, a group of patients (480 patients) with acute odontogenic inflammatory diseases of the maxillofacial region and neck were analyzed. The following indicators were evaluated: the number of facial and neck cell spaces involved in the inflammatory process, the depth of the lesion, as well as the presence of organ failure. The second block of research. To evaluate the effectiveness of the developed algorithm for determining the high probability of development of organ failure, the developed algorithm was tested on a group of patients with odontogenic inflammatory diseases (64 patients). An indicator of the effectiveness of early diagnosis and prediction of odontogenic organ failure was assessed (when the patient entered the hospital). Results. Between the involvement of deep cellular spaces of the maxillofacial region and the presence of organ failure there is a direct dependence. In patients with organ failure, lesions of 4 or more cellular spaces are most often observed. Discussion. To determine the high probability of development of organ failure, it is possible to study the number of involved cell spaces and / or the depth of lesion. For more purposeful observation, this technique should not be used in isolation, but must be combined with other methods of effective diagnosis. The conclusion. Phlegmon, which spreads to 4 or more cellular spaces, and / or involves the deep cellular spaces of the maxillofacial region, the cellular spaces of the neck, the mediastinum, is characterized by a high risk of organ failure.

The aimwas to assess the impact of emergency and planned tracheostomy on the main indicators of inpatient treatment in patients with contact mediastinitis.Materials and methods.This work was performed on the basis of the Department of Maxillofacial Surgery of the Kursk Regional Clinical Hospital. In order to conduct a comparative assessment of the treatment results, the patients with contact mediastinitis (46 people, surveyed period 2008–2017) were divided into 2 subgroups: control (25 people, 7 women, 18 men), who were treated without a tracheostomy; and the main group (21 people: 9 women, 12 men), with tracheostomy performed. The etiological and microbiological characteristics of the disease, the total duration of inpatient treatment, the length of stay in the resuscitation and intensive care units (bed-days), the dependence of the disease outcome (death, recovery) on the form of surgical intervention (tracheostomy) were evaluated.Results.A statistically significant effect of tracheostomy on the total duration of hospitalization and mortality rate was established (p0.05). Consequently, at present this issue cannot be resolved unambiguously and requires further research and mathematical analysis.Conclusion.The implementation of tracheostomy significantly increases the duration of inpatient treatment of patients with contact odontogenic mediastinites (p0.05).Conflict of interest: the authors declare no conflict of interest.

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