The Course of the Soft Tissues Inflammatory Process in the Maxillofacial Region against the Background of Chronic Alcohol Intoxication: Experimental and Clinical Study
Authors:   Danylo Halytsky Lviv National Medical University, Department of Oral and Maxillofacial Surgery. 69, Pekarska St., Lviv 79010, Ukraine, Leshchyshyn N. I. , Matolych U. D. , Vynarchuk-Paterega V. V. , Zakalyk M. S. 
Published: November 2022

The purpose of the study was to investigate, under experimental conditions, the peculiarities of the healing of infected wounds in experimental animals with long-term alcohol consumption; in patients with phlegmons of maxillofacial region against the background of alcohol intoxication, to evaluate the dynamics of hematological indices for determining the activity of the inflammatory process, predicting the course of the pathological process. Materials and methods. Experimental studies were conducted on 16 female Wistar rats weighing 80 g. The animals were divided into 2 equal groups: group I – experimental, group II – control. The water for the rats of the experimental group was replaced with beer, the alcohol content of which did not exceed 6%. 6 weeks after the start of the experiment, 2 rats from each group were removed from the experiment and material was taken for histological examination, the remaining 12 rats were anesthetized and wounds were created on the lower lip by cutting out a fragment of the mucous membrane measuring 0.4 x 0.3 cm. After the wounds were created, the animals were removed from the experiment by overdose with ether anesthesia on the 3rd and 7th day, the wounds were photographed, the mucous membrane of the lower lip was taken for histological examination. Results. In the experiment, during the histological examination of the tissues of the lower lip of rats with a model process of beer alcoholism, deformation of the sweat and sebaceous glands of the lower lip, and thinning of the epithelial layer were revealed. The healing of infected wounds of the lower lip in experimental animals was slowed down against the background of replacing drinking water with beer, and an objective decrease in proliferative processes was established. In particular, on the 7th day in the subepithelial layer, mixed cellular infiltration with lymphocytes, single leukocytes and macrophages was maintained, at the same time foci of young granulation tissue appeared in animals of the control group, which indicated the healing process. A retrospective analysis of 50 case histories of patients with odontogenic phlegmons of the maxillofacial region, localized in one topographical and anatomical space, was conducted, 16 of them abused alcoholic beverages. Before the phlegmon opening operation, on the 5th and 9th days, hematological indices of activity were determined – the lymphocyte-granulocyte index, the leukocyte to erythrocyte sedimentation rate ratio. The lymphocyte-granulocyte index was significantly lower (by 3.3 times) in patients who abused alcohol. On the 5th day, a significant increase in the lymphocyte-granulocyte index was found in the group of patients who abused alcohol. The analysis of the leukocyte to erythrocyte sedimentation rate ratio showed an increase in indicators in patients with phlegmons from the normal level. In patients with alcohol intoxication, on the 9th day, a 2.6-fold increase in the leukocyte to erythrocyte sedimentation rate ratio was found compared to the indicators of practically healthy individuals and 2-fold compared to the group of patients without harmful habits (p<0.05). Conclusion. According to hematological indices of inflammatory activity, it is possible to determine the degree of activation of the pathological process in patients, in particular, those who abuse alcohol, and to choose the tactics of treatment of phlegmon of maxillofacial region