Acoustic screening of abnormal scars in maxillofacial region

Background: Despite significant advances in the treatment of patients with inflammatory maxillofacial diseases, there have been cases of secondary cicatricial deformities in the face and neck area in patients with purulent and inflammatory diseases. The share of such cases in maxillofacial surgery hospitals is 77.5%–89.3% of total patients. The medical acoustic test used to diagnose abnormal scarring in patients with purulent and inflammatory maxillofacial and neck diseases allows for localizing the identified lesions based on anisotropic parameters, which is certainly relevant for treatment and prevention of soft tissue deformities in healthcare practices.

Aim: To substantiate the relevance of acoustic screening to improve diagnosis and prevention of secondary soft tissue deformities of the face and neck in patients with maxillofacial diseases.

Methods: The clinical study included 30 patients undergoing inpatient and outpatient observation in the maxillofacial surgery department and rehabilitation office of a multidisciplinary clinical hospital. The patients were divided into two groups. Group 1 comprised 15 patients with maxillofacial phlegmon of various origin, location, and localization of the affected tissue plane; group 2 comprised 15 patients after scheduled surgeries without signs of inflammation.

The study included physical examination; interviews to identify complaints, anamnesis morbi, and anamnesis vitae; investigations; radiological imaging and functional tests, acoustometry, and examination by a physician and anesthesiologist.

Integumentary tissues were evaluated using an acoustometer on postoperative days 1, 14, and 60. The mechanical skin properties were assessed around the wound by measuring the velocity V_p in orthogonal directions, including V_у along the vertical axis of the face and V_х along the horizontal axis of the face. Based on the measured values, the anisotropy coefficient K = V_у/V_х was calculated. V_n was simultaneously assessed in a similar region on the healthy side.

Results: Group 1 velocity changes during the study were more than 2.5 times higher than those in group 2.

The study proved that the velocity measured by an acoustic device in patients with purulent and inflammatory maxillofacial diseases is 2.5 times higher than the wave velocity in patients without signs of inflammation.

Conclusion: Changes in acoustic parameters recorded at different stages of wound healing in maxillofacial surgery objectively reflect the regeneration progress and allow for studying the type of abnormal scarring. Early diagnosis helps prevent the abnormal scarring and determine the medical, physical, or radiation therapy strategies.