Pediatric Maxillofacial Surgery Research Articles

Distraction osteogenesis in the treatment of transverse malocclusions in children

Relevance. Malocclusions accounts for 37% to 89% of all maxillofacial conditions in children aged 3 to 18 across various regions of Russia. These malocclusions can present as isolated issues in a single plane or as combined anomalies across multiple planes. Jaw narrowing or underdevelopment is influenced by various endogenous and exogenous factors. The choice of treatment depends on the severity of the malocclusion. While literature indicates several effective methods for treating transverse malocclusions, some aspects remain insufficiently explored.Materials and methods. A statistical analysis was conducted on 271 patient records of individuals with transverse malocclusions who received treatment in the Department of Pediatric Maxillofacial Surgery at A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, between 2013 and 2023.Results. There was an almost equal distribution of patients by gender, with a noticeable increase in medical consultations from 2013 to 2023. The majority of surgically treated patients were between 15 and 17 years old. Isolated transverse malocclusions were significantly less common than cases combined with other pathologies, with mesial occlusion being the most frequent comorbidity.Conclusion. The findings demonstrate a significant need for surgical treatment in pediatric patients with transverse malocclusions through distraction osteogenesis. This underscores the importance of continually improving treatment methods for children, including enhancing diagnostics, refining treatment indications, optimizing distraction protocols, and adjusting treatment courses. These efforts aim to improve the quality of rehabilitation for children, ensuring better outcomes into adulthood and facilitating their social adaptation.

Programmatic forecasting of treatment and diagnostic measures for congenital cleft lip and/or palate

Relevance. The documentation processes in medical organizations across the DPR are being restructured, particularly in relation to providing therapeutic and rehabilitative care for children with congenital maxillofacial anomalies. Significant changes have been made to both the requirements for medical documentation and the speed at which it is processed, thanks to advancements in information technology and the introduction of individual electronic medical records. In this era of medical digitalization, it is crucial to simplify data collection and improve the forecasting of the effectiveness of therapeutic and rehabilitative measures conducted at the Pediatric Maxillofacial Surgery Center in Donetsk.Materials and methods. To evaluate the effectiveness of forecasting therapeutic and rehabilitative measures using the "Outpatient Monitoring" software, a previously developed model for predicting treatment outcomes was used. This model is based on an analysis of factors and indicators that reflect different aspects of the treatment and rehabilitation process for children with cleft lip and/or palate.Results. The study led to the implementation of a methodology for forecasting the effectiveness of therapeutic and rehabilitative measures at the Pediatric Maxillofacial Surgery Center in Donetsk, utilizing the "Outpatient Monitoring" computer-based accounting and analytical software, which facilitates both practical and scientific tasks related to the monitoring, treatment, and rehabilitation of children with cleft lip and/or palate.Conclusion. The developed forecasting model will greatly simplify the work of specialists at the Pediatric Maxillofacial Surgery Center.

Clinical application of "Ethoxysclerol" and "Bleomycin" in the management of retention cysts of the salivary glands in pediatric patients: case studies

Relevance. Retention cysts of the salivary glands are a frequent occurrence in dental practice. Traditional treatments, such as cystadenectomy and cystotomy, are commonly employed. However, these procedures are associated with postoperative complications, including recurrence, damage to adjacent structures (e.g., ducts of neighbouring salivary glands, blood vessels, and nerves), and inadvertent opening of the submandibular salivary gland capsule.Description of clinical cases. This paper presents clinical cases of four pediatric patients diagnosed with retention cysts of the salivary glands, treated at the Department of Pediatric Maxillofacial Surgery, Russian University of Medicine. All patients received treatment with "Lauromacrogol-400" ("Ethoxysclerol") and "Bleomycin." In the postoperative period, no complications or adverse effects related to the administered drugs were observed. Follow-up examinations revealed no clinical manifestations of retention cysts or ultrasonographic evidence of cysts.Conclusions. Sclerotherapy using "Ethoxysclerol" and "Bleomycin" for the treatment of retention cysts of the salivary glands presents a viable minimally invasive alternative to conventional surgical methods, potentially mitigating the risks associated with more invasive procedures.

Analysis of the use of classical compression–distraction devices and the latest device for continuous distraction

BACKGROUND: The device used in bone tissue fragment mechanical displacement by expanding the piston between rigidly fixed device legs on the bone fragments is known in classical compression–distraction osteogenesis. In such cases, the control of the displacement is partly left to the patient, since the screw turning must be performed in four sessions per day, and the doctor does not constantly have the opportunity to do it personally, which can lead to uncontrollable results of bone regeneration. To fully control the patient's treatment during distraction, a device that operates continuously and autonomously is required.
 AIM: Creation and experimental testing of an automatic distraction device for continuous distraction followed by a study of the obtained bone regenerates and its implementation in practical maxillofacial surgery.
 MATERIALS AND METHODS: To fully control the patient’s treatment during the distraction, we developed an unparalleled distraction device based on the principle of continuous bone fragment separation, with a motor in which the piston is activated by an electrochemical reaction. The device performs distraction continuously, around the clock, and autonomously under the control and monitoring of the software and the possibility of remote access. This study included analysis of statistical data on patient treatment in the Russian University of Medicine Department of Pediatric Maxillofacial Surgery Clinic between 2010 and 2021, development and bench testing of devices and electronics, clinical trials of models of devices for continuous distraction at various rates (1, 2, and 3 mm/day) on experimental animals (dogs), X-ray control at the stages of testing, research and analysis of the morphological structure of the resulting bone regenerates, creation of clinical guidelines for the use of a continuous distraction day device, and identification of its advantages compared with the classic fractional compression–distraction device.
 RESULTS: Statistical data analysis revealed that 362 patients were treated with distraction devices. This is a relatively high percentage in relation to all patients in the clinic. Studies of the morphological structure of regenerates obtained by continuous distraction with our latest device revealed a higher rate and control of regenerates, good quality characteristics, and histomorphological maturity, most pronounced in regenerates obtained by continuous distraction at a rate of 2 mm/day.
 CONCLUSION: The need for treatment with distraction osteogenesis in the department’s clinic is rather high; hence, this process should be controlled to improve treatment quality and speed. Our automatic distraction device designed for continuous distraction may be implemented and applied in practical medicine at an appropriate rate of 2 mm/day.

Comprehensive management of Pindborg tumor in childhood: a case report

Relevance. The calcifying epithelial odontogenic tumor, also known as Pindborg tumor, is a locally aggressive neoplasm characterized by strands and medullary formations of flat and clear cells, often accompanied by spherical calcifications and amyloid-stained hyaline deposits. The Pindborg tumor is rare, representing less than 1% of odontogenic tumors, and typically manifests in individuals aged 20 to 60 years. However, there is a growing incidence of neoplasms of diverse origins in childhood. This article presents a clinical case detailing the comprehensive multi-stage treatment of a pediatric patient with a Pindborg tumor, facilitating complete rehabilitation before reaching adulthood.Clinical case description. This article presents a clinical case detailing the comprehensive management of a patient with a Pindborg tumor. The individual initially sought treatment at the Department of Pediatric Maxillofacial Surgery of A.I. Evdokimov Moscow State Medical and Dental University in 2020, undergoing complete combined treatment until November 2023. Full rehabilitation was successfully achieved by the time of adulthood through a series of four consecutive surgeries, including dental implantation, followed by prosthetics utilizing a non-removable orthopedic structure in the final stage.Conclusion. Initiating comprehensive rehabilitation at an early stage, including dental implantation before reaching adulthood, facilitates complete social adaptation in society and contributes to the patient's harmonious development.

Рожистое воспаление у детей в практике педиатра

Aim. To present a clinical case of atypical erysipelas, complicated by an allergic reaction, in a 10-year-old child. Key points. Erysipelas is an urgent medical and social problem, and, despite the success of antibacterial therapy, its frequency does not tend to decrease. Erysipelas belongs to the group of pyoderma and occupies a leading place in the structure of purulent-septic diseases. The main etiological factor of erysipelas is considered to be group A Streptococcus. However, the ineffectiveness of traditional antibacterial therapy regimens speaks in favor of the polyetiological nature of this disease and requires great attention in choosing the starting drug. In children, the erythematous-bullous form is more common, which may require differential diagnosis not only with infectious diseases, but also with a number of allergic diseases with the prescription of desensitizing therapy. The article examines a clinical case of an atypical course of erysipelas in the area of the right half of the face, complicated by an allergic reaction in a 10-year-old girl. The ineffectiveness of initial antibacterial therapy and its correction based on the clinical picture, taking into account the negative results of laboratory tests, have been demonstrated. Conclusion. Erysipelas in children with a burdened premorbid background, especially with atypical forms, requires great attention from doctors, since in these cases, if therapy is ineffective, the risk of complications may be increased. Keywords: erysipelas, children, pediatric maxillofacial surgery, Streptococcus pyogenes, Staphylococcus aureus.

Impact of the Sanitary Confinement Resulting From COVID 19 on Pediatric Emergencies in Maxillofacial Surgery

The pediatric population constitutes a large part of the admissions to maxillofacial emergencies, the health confinement following the declaration of the state of alert as a consequence of the COVID 19 pandemic has modified the behavior of the Moroccan population. In order to study the impact of the lockdown on pediatric maxillofacial emergencies, we conducted a retrospective descriptive and comparative study over a period of 2 months from February 16, 2020 to April 16, 2020: one month before and during the lockdown following the COVID 19 pandemic of pediatric maxillofacial surgery emergency admissions at the MOHAMMED the 6th University Hospital of MARRAKECH. We included the entire pediatric population admitted to the maxillofacial surgery emergency room, ranging from 0 to 15 years of age. The data were collected from the registers of maxillofacial surgery emergencies for two consecutive years.

Paediatric Mandibular Fracture Management - A Seven Year Retrospective Study.

Mandibular fractures are one of the most frequent and complex types of traumatic injuries of the maxillofacial region in children. Given significant long-term sequelae of inappropriate healing, adequate diagnosis and choice of management, which takes into account the patient's age and fracture characteristics, are paramount. The data for this study were obtained from the medical records of patients treated in the Department of Surgical Dentistry and Paediatric Maxillofacial Surgery of the Bogomolets National Medical University from 2014 to 2020. Age, gender, fracture pattern and surgical treatment methods performed in these patients were recorded and analysed. A total of 302 children with 376 traumatic fractures of the mandible were managed during the study period. The largest number of fractures was found in the condylar processes region, 42%, and in the body of the mandible, 40%. The majority of patients were males and in the 13-17 age group (147 [49%] cases). Tigerstedt's maxillary-mandibular fixation splint was used in the majority of cases, alone or in the combination with open or internal fixation. Whilst the most common type of immobilisation in children in our series was Tigerstedt's maxillary-mandibular fixation splint, its use is limited to the variable bite period. Alternative fixation options are discussed.

Risk factors for the formation of congenital hyperplasia of blood vessels (infantile hemangioma)

The aim the study. To identify correlations between the development of blood vessel hyperplasia (GCS) and risk factors in pregnant women. To identify correlations between the development of blood vessel hyperplasia (GCS) and risk factors in pregnant women. A selective retrospective analysis of 173 case histories and outpatient records of patients of the Clinic of Pediatric Maxillofacial Surgery and Dentistry of the Central Research Institute of Dentistry and Maxillofacial Surgery for 2011-2021 was carried out. The obstetric history of the mother, chronic diseases of mothers during pregnancy and bad habits were studied. The interrelation of the influencing unfavorable factor on the isolation, prevalence and vastness of foci of infantile hemangioma was determined. There was no statistically significant relationship between the harmful habits of the mother and the number of lesions, as well as the isolation of the lesion of the mandibular-facial region (CHLO) and the prevalence of the process in the child. It was found that the prevalence of the process, the isolation of the lesion and the number of foci of CHLO did not have a reliable relationship with the complicated course of pregnancy in the mother. A reliable relationship was revealed between the number of lesions in the CHLO and chronic hypoxia, between the number of defects of the cardiovascular system and the prevalence of the process. But there was no reliable relationship between the number of CCC lesions and the number of lesions. 24 patients out of 173 were premature. In these patients, a statistical severity to the occurrence of GCS was revealed. There was no reliable relationship between the genetic predisposition on the line of both parents and the prevalence of the process, with the isolation of the lesion of CHLO and with the number of foci of CHLO lesions. Prematurity, chronic hypoxia, multiple malformations of the fetal cardiovascular system are risk factors for the development of vascular hyperplasia in children.

Endoscopic tooth extraction after intrusion into the maxillary sinus in a teenager: a clinical case

Relevance . One of the complications of maxillary tooth extraction is its intrusion into the maxillary sinus due to the peculiarities of the anatomy of the upper jaw and possible technical errors of the doctor. The extranasal approach is the most common treatment method of this pathology, namely the Caldwell-Luke surgery (radical antrostomy) or oroantral communication closure and removal of a foreign body from a maxillary sinus. Diagnosis . This article describes two clinical cases. Both patients were admitted to the Pediatric Maxillofacial Surgery Unit with a diagnosis of Foreign body in the maxillary sinus. The paper presents our experience on the endoscopic removal of a foreign body from the TMJ in these patients. Results . Endoscopic removal of foreign bodies from the maxillary sinus was the treatment method in these patients. The postoperative period was unremarkable and without complications. Conclusions . We currently believe that the endoscopic approach to tooth removal from the maxillary sinus is a solution that should be adhered to by all modern surgeons since this method is less invasive and has a short recovery period.

АНАЛИЗ СТРУКТУРНО-ОРГАНИЗАЦИОННОЙ ПЕРЕСТРОЙКИ МЕДИЦИНСКОЙ ПОМОЩИ ДЕТСКОЙ ЧЕЛЮСТНО-ЛИЦЕВОЙ ХИРУРГИИ В ПЕНЗЕНСКОМ РЕГИОНЕ В 2021 ГОДУ

The annual increase in patients and increased requirements for the quality of medical care lead to the reorganization of the work of various departments of medical hospitals. In order to improve the quality and accessibility of specialized medical care in the profile "maxillofacial surgery" in the territory of the Penza Region, in 2020, the structure of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko will be reorganized, which allows solving a number of existing problems. An important direction in the modernization of the Center was the structural and organizational restructuring. The purpose of the study: to analyze the quality and effectiveness of providing care to children with pathology of the maxillofacial region by doctors of the Center for Maxillofacial Surgery of the Penza Regional Clinical Hospital named after N. N. Burdenko. Materials and methods. A comprehensive assessment of the quality of care for children with maxillofacial pathology from 2018-2020 in the Penza region and in the period from November 2020 to July 2021 was carried out. Center of Maxillofacial Surgery of the N. N. Burdenko State Medical University. Results and discussion. Having analyzed the existing shortcomings and problems, established connections, the growth of patients in need of treatment by a maxillofacial surgeon contributed to the opening of the Maxillofacial Surgery Center in the N. N. Burdenko State Medical University, which included 10 specialized children's beds; 2 ultra-short stay beds; an outpatient office; a rehabilitation room; material and technical equipment, tools, medicines for children; maxillofacial surgeon, pediatrician, pediatric dentist, general dentist, clinical nurses, speech therapist. Conclusion. The opening of the Maxillofacial Surgery Center in the Penza region has shown high efficiency. The economic effect in obtaining specialized treatment due to the work of an outpatient office and a rehabilitation office based on a patient-oriented model is noted. In order to achieve maximum efficiency and fully meet the need for providing medical care to the children's population of the Penza region in the profile "maxillofacial surgery", it is necessary to open a department of pediatric maxillofacial surgery due to the projected workload of open beds.

The Structure of Oral and Maxillofacial Illness among Mongolian Children

The Department of Pediatric Maxillofacial Surgery of the National Center for Maternal and Child Health (NCMCH) has a nationwide tertiary medical service on the patients who is with congenital oral and maxillofacial anomalies

Head and neck tumors in children. The role of the questionnaire in detecting the frequency of tumors in children

Head and neck tumors in children. The role of the questionnaire in detecting the frequency of tumors in children. Children have differences in their physiology, anatomy and they are continuing to grow and develop. The management of pathology, trauma, deformity and upper airway obstruction in the young growing patient has to take into account these factors in the treatment planning for these conditions. It is important for Oral & Maxillofacial Surgeons to understand the potential impact of disease or injury on the developing facial skeleton and dentition. This aticle provide an overview of the some of the major components and special tumors of pediatric maxillofacial surgery and their management.

Treatment of a child with venolymphatic malformation of the tongue

Relevance. Lymphatic and venolymphatic malformations account for 6-18% of benign lesions in children. In most cases, the head and neck regions are affected, with 50% of intraoral lesions occurring in the tongue. Venolymphatic malformation of the tongue leads to severe functional problems, even life-threatening, to serious esthetic defects and social maladjustment. Diagnosis and treatment of this patient population is a difficult and unsolved problem in pediatric maxillofacial surgery since there is no common algorithm for managing such patients. Purpose – optimization and improvement of the rehabilitation’s effectiveness of children with lymphatic and venolymphatic malformations of the tongue by creating a clear algorithm for the diagnosis and treatment of this patients’ group.Materials and methods. A child aged 1 year and 5 months was treated for venolymphatic malformation of the tongue, macroglossia. In addition to general clinical examination methods, the mandatory diagnostic methods were ultrasonography of pathological tissues, MRI (magnetic resonance imaging) and CT (computed tomography) of the head and neck with intravenous administration of a contrast agent, fibrolaryngoscopy. The child was operated on in two stages: the first stage was a refined resection of the tongue followed by its plastic surgery with the local tissues, the second stage was the removal of the superficial malformation of the tongue using a semiconductor laser LSPIRE-Polyus (ЛСП-«ИРЭ-Полюс»). The surgery was performed under the general anaesthesia. A histopathological examination of the specimen was performed to clarify the diagnosis.Results. The outcome of the treatment was good: functional and esthetic problems were solved, the child became socially adapted. There were no complications during the intra- and postoperative periods. The method of removing the superficial form of venolymphatic malformation of the tongue using a semiconductor laser has once again demonstrated its effectiveness (patent for invention No. 2676832).Conclusions. When examining such children, it is necessary to adhere to a specific diagnostic plan. The treatment of this patients’ group is interdisciplinary and comprehensive, with the obligatory adherence to a clear treatment algorithm, which allows achieving good functional and esthetic outcome. The advantages of laser treatment of the superficial form of venolymphatic malformation of the tongue are the reduction in the risk of recurrence due to the complete and immediate removal of pathological tissues; decrease of the invasiveness of the operation for the precise action of the laser radiation, as well as the simultaneous coagulating effect of laser radiation; improving the functional and esthetic outcome of treatment; reducing the cost of treatment for this group of patients by decreasing the period of the hospital stay.

Probability assessment of facial nerve injury in children and adolescents during the elective maxillofacial surgery

Relevance. Various factors can cause facial neuropathy. Iatrogenic facial nerve injury in childhood and adolescence is a complicated medical, psychological and legal problem. Risk assessment of the facial nerve injury during the elective maxillofacial surgeries is required depending on the localization of the procedure. The statistical assessment is very important for the evaluation of the possible iatrogenic facial neuropathy in children and adolescents during the elective maxillofacial surgeries.Materials and methods. 715 medical records for 2017 from the Department of Pediatric Maxillofacial Surgery of the MSUMD Clinical Center for Maxillofacial, Reconstructive and Plastic Surgery were analyzed.Results. There was a risk of injury to the trunk or branches of the facial nerve during surgery in 121 cases (16,9%) for the technical complexity of the surgical approach and the pathology location.Conclusions. There is a high risk of the facial nerve injury during the elective maxillofacial surgery in children and adolescents due to the complex anatomy of the area. Intraoperative neuromonitoring is recommended to prevent iatrogenic neuropathy of the facial nerve.

Patterns of Paediatric Maxillofacial Fractures: A Twelve-Year Retrospective Study

In this study was to analyse the patterns of maxillofacial fractures in children under 18 years of age admittedat paediatric maxillofacial surgery department in Tashkent state dental institute, Uzbekistan in a period of 12years between January 2007 and December 2018.Out of 757 children with maxillofacial bone fractures, themajority were aged between 6-18 years (78,6%, n=595). The mean (±SD) age was 9.3±0.5 years and maleto female ratio was 6.2:1. Falls was the most frequent mode of injury (46,9%, n=355). The mandible wasmost commonly involved (67.2%, n=509) of the cases. The incidence of paediatrics maxillofacial fracturesin Uzbekistan region was high. The 6-18-year olds and boys were most commonly involved in maxillofacialpaediatrics trauma. Mandibular fractures were the most common type of fracture. Safety programs shouldbe instituted in Uzbekistan region to increase public awareness and to decrease morbidity resulting frompaediatrics maxillofacial trauma.

Etiology and patterns of pediatric maxillofacial fractures in the Uzbekistan

In this study was to analyze the patterns of maxillofacial fractures in children under 18 years of age admitted at paediatric maxillofacial surgery department in Tashkent state dental institute, Uzbekistan in a period of 12 years between January 2007 and December 2018. Out of 757 children with maxillofacial bone fractures, the majority were aged between 6 and 18 years (78,6%, n = 595). The mean (±SD) age was 9.3 ± 0.5 years and male to female ratio was 6.2:1. Falls was the most frequent mode of injury (46,9%, n = 355). The mandible was most commonly involved (67.2%, n = 509) of the cases. The incidence of paediatrics maxillofacial fractures in Uzbekistan region was high. The 6-18-year olds and boys were most commonly involved in maxillofacial paediatrics trauma. Mandibular fractures were the most common type of fracture. Safety programs should be instituted in Uzbekistan region to increase public awareness and to decrease morbidity resulting from paediatrics maxillofacial trauma.

The use of various types of autografts in the bone grafting of the alveolar process

Relevance. Fixing a cleft alveolar process is one of the most complicated problems in pediatric maxillofacial surgery. The difficulty lies in the fact that bone grafting of the alveolar process directly affects the growth of the upper jaw, the difficulty of performing surgery, as well as trying to form a sufficient amount of bone regenerate, while it is necessary to restore the anatomical integrity of the alveolar process for subsequent orthodontic treatment or dental implantation. Purpose: To review the literature on the use of autografts from various donor areas in patients with congenital cleft upper lip, alveolar process, hard and soft palate. Materials and methods: A literature review of the data was carried out using the electronic databases “Medline”, “Pubmed”, “Kibeleninka”. The key words in the search were: bone plastic, cleft alveolar process. The selection criteria were the articles in English and Russian containing clinical studies on the use of various types of grafts in bone grafting of the alveolar process cleft. Results: The sources of literature on the use of various autografts for bone grafting of the alveolar outgrowth in children with cleft lip and palate were analyzed. Currently, most authors are inclined to use an iliac crest autograft in surgery. Conclusion: Although more than a century has passed since the first alveolar cleft bone graft surgery was performed, the choice of bone material is still unresolved - due to the severity of complications, the impossibility of taking a sufficient amount of bone material, as well as a high percentage of material resorption, because even with the use of iliac crest bone, the volume of transplant resorption can be over 40%.

DERMOID AND EPIDERMOID CYSTS OF THE MAXILLOFACIAL AREA AND THE NECK AMONG CHILDREN

It is generally accepted that dermoid and epidermoid cysts are the result of malformation of the ectoderm. The asymptomatic course, absence of pathognomonic symptoms and similarity of clinical manifestations at separate stages of growth, despite nosological form and place of occurrence, give this pathology of particular relevance in the practice of pediatric maxillofacial surgery.
 However, if there are no significant issues regarding the etiology and pathogenesis of dermoids and epidermoids, there is a problem of constant monitoring of their prevalence and structure for the formation of administrative organizational measures for the planning of specialized care for this category of patients. Special attention should also be given to the development of new, minimally invasive surgical interventions, given the increasing aesthetic demands and requirements of patients.
 The aim of the study is to study in a comparative aspect their own experience on the clinical and morphological features and principles of treatment of dermoid and epidermoid cysts of the maxillofacial area and neck in children with the results of scientific studies, covered in literature.
 A thorough analysis of fundamental scientific works and publications in periodicals devoted to the scientific development of various directions in relation to these issues is carried out.
 The clinical section of the work concerns 15 children with dermoids and 8 children with epidermoids who have been treated for 8 years in the surgical ward of the children's clinical hospital in Poltava. General clinical, additional, and specific examination methods were used to establish clinical diagnosis, including diagnostic puncture, ultrasound, and MRI examination, which was performed in complex and questionable cases. If it is necessary, the patients are consulted by doctors of related specialties.
 The microscopic structure of the postoperative material was studied on preparations made by conventional methods.
 An objective study found that the clinical picture of the dermoid and epidermoid cysts is similar, differing only in slight subjective sensations on palpation.
 Comparison of clinical diagnosis and results of postoperative morphological verification of removed soft tissue bones showed that in 23.9% of patients the clinical diagnosis did not coincide with pathohistological. The difference in dermoids was the largest (75.0%), which confirms the need for expanded use of additional examination methods both at the pre-hospital stage and under inpatient conditions immediately before surgery.
 In general, the obtained morphological picture of the postoperative material coincided with the literature data on the classical structure of the dermoid and epidermoid cysts of the soft tissues of the maxillofacial area.
 Thus, the dermoid and epidermoid cysts of the maxillofacial area in children, having a dysontogenic origin, are most often diagnosed at younger and older school age. Despite their classic clinical picture, a considerable number of discrepancies between clinical and pathohistological diagnoses are traced , requiring a careful examination at both the hospital and hospital stages using modern, informative supplementary and special methods of investigation in complex and doubtful cases of cases and complex cases.
 These materials may be the basis for further in-depth scientific studies on immunohistochemical structural features dermoids and epidermoids to determine immunocompetence layers cystic membranes and determine their probable role in causing acute inflammation depending on the type of formation.

Paediatric oral & maxillofacial surgery.

Children have differences in their physiology, anatomy and they are continuing to grow and develop. The management of pathology, trauma, deformity and upper airway obstruction in the young growing patient has to take into account these factors in the treatment planning for these conditions. It is important for Oral & Maxillofacial Surgeons to understand the potential impact of disease or injury on the developing facial skeleton and dentition. This chapter will provide an overview of the some of the major components of paediatric maxillofacial surgery and their management.