DYNAMICS OF COGNITIVE FUNCTION OF PATIENTS WITH DEFECTS OF THE SKULL AFTER RECONSTRUCTIVE SURGERY

Abstract

Due to the high social significance of traumatic brain injury and its consequences, dynamics of cognitive functions at the background of the reduction of reconstructive and plastic surgery is of interest to researchers in the world, but this topic is not sufficiently studied. A large number of patients with bone defects of the skull due to a traumatic brain injury and skull defects after surgery for tumors, and as a consequence of possible cognitive deficits of these patients makes it necessary to study and assess the possibility of its compensation as a result of reconstructive plastic surgery of the skull. Material and methods. In our study, we examined 54 patients (12 women and 42 men) in surgical treatment neurotrauma department (reconstructive surgery) after traumatic brain injury or skull defect after surgical removal of tumors. The average age of patients is 33,09 years. All patients were examined by a psychologist before surgery, and on the first, third, and seventh-eighth day after the surgery. MoCA, FAB, Schulte tables, HADS, Spielberger-Hanin anxiety test, a set of stimulus materials for neuropsychological diagnosis, all patients were asked to subjectively evaluate their appearance: until defect acquisition prior to surgery after treatment (see questionnaire by Sinbukhova E.[8]), also was used projective drawing method, where patients were asked to perform a series of drawings on the given topics. In our study to reduce the high level of situational and personal anxiety of the patients they had Art-therapy sessions with a psychologist before surgery and from the second day after it. The purpose of research is to study the changes in cognitive function, level of depression, anxiety of patients with postoperative bone defects of the skull after a reconstructive-plastic surgery. Keywords cognitive function, depression, anxiety, reconstructive surgery. Results On the 3 days after surgery, a statistically significant increase was observed in the evaluation acording MoCA (preoperative mean value — 22 points, 3 days after the operation — 24 points, p = 0,0002033). Before сheck out (MoCA) significant improvement in cognitive function was confirmed. Depression, personal and situational anxiety was significantly reduced by the time сheck out. By the time of сheck out the emotional state of the patients showed significant improvement of emotional state level to the level prior to the defect acquisition. Subjective evaluation of appearance by the time of сheck out of patients showed a significant recovery of subjective apearance evaluation of the level prior to the defect acquisition. Conclusion. The obtained data revealed a statistically significant increase of early postoperative cognitive function of the background of reconstructive-plastic surgery. Statistically significant results of the reduction of depression, situational and personal anxiety, improvement of the emotional state of patients after surgery, at the background of daily Art-therapy (projective drawing) sessions with a psychologis.