A standard protocol for superficial lymph node (LN) ultrasound is presented. The document consists of a technological (1) and descriptive (2) protocols. The technological protocol describes the technique of superficial LN ultrasound. The descriptive protocol contains a detailed report of the results of superficial LN ultrasound, which ends with a conclusion. Modern domestic and foreign clinical and diagnostic recommendations that determine the indications for superficial LN ultrasound are analyzed.The presented standard protocol for superficial LN ultrasound fully complies with current Russian clinical recommendations and does not contradict foreign clinical and diagnostic recommendations.

Purpose of the study: to show the significance of ultrasound diagnostics in assessing the dynamics of the spleen mass coefficient in children of various age against the background of a chronic form of EBV virus.Materials and methods. The study was performed on 146 children aged 3 to 18 years suffering from chronic EBV virus. Depending on age, the children were divided into 3 groups. Group 1 included 63 patients aged 3 to 7 years; Group 2 consisted of 28 children aged 8 to 11 years; Group 3 included 55 children aged 12 to 18 years. The clinical, laboratory and ultrasound examination was conducted including ultrasound of the spleen with the further determination of its mass coefficient (SMC).Results. In the acute period of EBV virus, children of all age groups revealed an increase in SMC, while the maximum increase was observed in children aged 3 to 7 years and amounted to 6,88. Against the background of a complete clinical and laboratory recovery in this age group, the SMC remained at the level of 4.66 and did not reach the average values of healthy children of the same age. The follow-up dynamics for 15–18 months demonstrated the normalization of the SMC to the average values of healthy patients in accordance with their age (in children aged 12 years and older).Findings. Children in the age group from 3 to 7 years old had the maximum value of the spleen mass coefficient, both in the acute period and after complete clinical and laboratory recovery. The use of ultrasound technique with the assessment of the spleen mass coefficient in the chronic course of EBV virus allows expanding and determining the children contingent for further dynamic monitoring for prevention of possible complications.

Objective: To determine the diagnostic significance of sonographic signs indicating the parotid glands’ condition in children with juvenile recurrent parotitis (JRP). Materials and methods: We examined 42 patients with JRP and 30 children aged 3-17 years from the control group. Both groups underwent B-mode and color Doppler ultrasonography of parotid glands to assess linear dimensions, contours, structures, echogenicity, pronouncement of the stromal component, parenchymal vascularization, and condition of intraglandular lymph nodes. The diagnostic significance of the sonographic signs was assessed by ROC analysis. Results and discussion: We found significant differences between the study and control groups in terms of such sonographic signs as gland enlargement, decreased parenchymal echogenicity, change in the echotexture, increased stromal component, increased parenchymal vascularization, and reactive parotid lymph nodes (P < .05). With the high-frequency probe we were able to study the structure of JRP-associated hypoechoic foci in the parenchyma and prove that they are not cystic dilatation of the ducts but foci of infiltration around the peripheral ducts with structurally altered walls. Conclusions: Ultrasonography plays a pivotal role in the JRP diagnosis and can identify its most significant sonographic signs, such as increased size, distinctive changes in the parenchymal echotexture, decreased echogenicity, and increased parenchymal vascularization.

OBJECTIVE:The aim of the study is to determine the main clinical symptoms and ultrasound manifestations of secondary lymphedema of the maxillofacial region.MATERIAL AND METHODS:This study is based on the study of a comprehensive examination and the effectiveness of treatment of 15 patients diagnosed with lymphedema of the maxillofacial region, who are on outpatient treatment at the Federal State Budgetary Institution "National Medical Research Centre for Dental and Maxillofacial Surgery" of the Ministry of Health of the Russian Federation from 2020-2021 at the age of 18 to 70 years. The examination of patients included the study of complaints, anamnesis of life, anamnesis of the disease, external examination and examination of the oral cavity, palpation of soft tissues of the maxillofacial region, X-ray examination (if necessary). All patients underwent ultrasound examination of the soft tissues of the maxillofacial area.RESULTS:When examining patients, it was revealed that the main clinical symptoms of lymphedema of the maxillofacial region are the presence of edema, a feeling of heaviness and stiffness of movements in the area of edema and the absence of symptoms of inflammation such as fever, hyperemia and pain. 100% of patients had the following ultrasound manifestations in the area of lymphatic drainage disorders: an increase in tissue thickness, impaired tissue differentiation into layers, a diffuse increase in tissue echogenicity, and the presence of dilated lymphatic vessels.CONCLUSION:Lymphedema of the maxillofacial region is a polyetiological disease that is difficult to diagnose, requiring a thorough examination of the patient, including basic examination methods, radiography, and mandatory ultrasound examination of soft tissues.

OBJECTIVE:The aim of study was to improve the effectiveness of treatment of patients with secondary postoperative lymphedema of the maxillofacial region using lymphotropic therapy.MATERIAL AND METHODS:During 2020-2021 8 patients aged 40 to 70 years with secondary postoperative lymphedema of the maxillofacial region were treated in the Central Research Institute of Dentistry and Maxillofacial Surgery. The article presents the clinical and ultrasound results of a study of the effectiveness of the lymphotropic therapy in the treatment of patients with secondary lymphedema of the maxillofacial region.RESULTS:Six patients with an early stage of lymphedema had a complete regression of edema and normalization of the ultrasound picture of the soft tissues of the maxillofacial region. In 2 patients with late-stage lymphedema there was a regression of edema, but the preservation of residual swelling of soft tissues and signs of fibro-fatty transformation of soft tissues were revealed on ultrasound examination.CONCLUSION:Lymphotropic therapy with antifibrotic and anti-inflammatory drugs is one of the effective methods of treating postoperative secondary lymphedema of the maxillofacial region at the early stages of the disease.

The article is a review of the latest literature data on lymphedema of the head and neck, its etiology, pathogenesis, classification and main clinical manifestations. The main methods of diagnosis and treatment of this pathology are indicated.

OBJECTIVE:To evaluate the effectiveness of different approaches to the treatment of patients with hypertrophy of the palatine tonsils (HPT).MATERIAL AND METHODS:90 children with HPT of II-III degree and 20 healthy children (group 1) aged from 3 to 7 years were included in the study. Children with HPT were divided into three groups: group 2 - children who underwent tonsillotomy (n=30), group 3 - children who underwent conservative treatment, including only topical use of Polyoxidonium (n=30), group 4 - children who underwent complex treatment (tonsillotomy with subsequent local use of Polyoxidonium), (n=30). The severity of nasal breathing disturbances on a visual analogue scale, the average number of acute respiratory viral infections 6 months before and after treatment, the level of gene expression of antimicrobial peptides before and after treatment, the degree of hypertrophy of the palatine tonsils and spleen with an assessment of the echostructure and determination of the spleen mass coefficient using Ultrasound were evaluated in the study.RESULTS:In children receiving only Polyoxidonium, there was a decrease in the severity of nasal breathing disorders, a decrease in the frequency of acute respiratory viral infections, an increase in the expression of antimicrobial peptide genes compared to the initial level of these indicators. Comprehensive treatment of children with HPT (group 4) showed a significant decrease in the severity of nasal breathing disorders, a decrease in the average number of acute respiratory infections within 6 months, an increase in the expression of antimicrobial peptide genes compared to children who underwent only tonsillotomy (group 2) or only conservative therapy (group 3).CONCLUSION:It is proved that the use of Polyoxidonium in the complex treatment of HPT is clinically effective and safe.

The article presents literature data on the use of lymphatic methods therapy in complex treatment of patients with diseases of various nosologies in general surgery and dentistry. Clinically and experimentally obtained data on the advantage of lymphatic therapy compared with other methods of drug administration are indicated.

The purpose of the study is to determine early non-invasive (ultrasound) diagnostic criteria of splenomegaly in neonates with a high risk of congenital or postnatal infection.Materials and methods. In the prospective study, 163 newborn infants of the first week of live were included. All neonates included in the study were classified as possessing a high risk of an intra-uterine infection (IUI). Depending on the birth weight, the infants were split into two groups: group «А» — 80 full-term newborns with normal birth weight, and group «В» — 83 full-term newborns with fetal growth restriction (FGR). A comprehensive examination of newborns including spleen ultrasound was carried out.Results. An increased spleen weight coefficient (Km) was found in newborns with high risk of infection development that included congenital oromaxillofacial and gastrointestinal defects, perinatal contacts with various microorganism. The increased spleen weight and Km reflected conditions of the immune system organ of the newborn in response to an adverse exposure including infection.Conclusion. Ultrasound examination of morphometrical characteristics of the spleen in newborns with various medical conditions represents a convenient and simple method of early diagnosis of splenomegaly. The most sensitive index is the spleen weight coefficient (Km), which reflects the immune system organ response to an adverse perinatal exposure including contact with an infectious agent. The mean spleen weight coefficient is within the range of 1.1 to 3.0. When the index exceeds 4, the risk of development of an infectious disease increases. This method can be used as a screening approach for newborns of different gestation age who have been included in the high-risk group based on a congenital or early postnatal infection.

The study was aimed at establishing a new ultrasonic criterion of evaluating spleen dimensions in children (area of the maximum axial section) and determining the range of normal spleen dimensions. Patients and methods: We analyzed 838 ultrasonic spleen examinations in 3‑15‑year-old children and determined the area of the maximum axial section by tracing the scan obtained with a medical device. Results: on the basis of ultrasonic examination data analysis, we established a formula, which helps to calculate the spleen section area with the organ’s length and thickness. We performed retrospective analysis of 4,001 standard ultrasonic examinations followed by formula evaluation of the area of maximum axial section. Conclusion: on the basis of the comparative analysis of the measured and calculated areas of the maximum spleen axial section, we established a range of normal values of this parameter taking age and sex into account.

The study was aimed at establishing a new ultrasonic criterion of evaluating spleen dimensions in children (area of the maximum axial section) and determining the range of normal spleen dimensions. Patients and methods: We analyzed 838 ultrasonic spleen examinations in 3‑15‑year-old children and determined the area of the maximum axial section by tracing the scan obtained with a medical device. Results: on the basis of ultrasonic examination data analysis, we established a formula, which helps to calculate the spleen section area with the organ’s length and thickness. We performed retrospective analysis of 4,001 standard ultrasonic examinations followed by formula evaluation of the area of maximum axial section. Conclusion: on the basis of the comparative analysis of the measured and calculated areas of the maximum spleen axial section, we established a range of normal values of this parameter taking age and sex into account.

С целью выявления особенностей дисфункциональных расстройств билиарного тракта у детей, проживающих в условиях воздействия хрома, никеля и хлороформа, проведено динамическое ультразвуковое исследование желчного пузыря 120 детям в возрасте от 4 до 15 лет и 55 детям аналогичной возрастной категории, живущим на территории относительного санитарно-гигиенического благополучия. На основании проведенного ультразвукового исследования функции желчного пузыря выявлено, что дисфункциональные расстройства билиарного тракта достоверно чаще (в 1,4 раза) встречались у детей с повышенным содержанием в крови хрома, никеля и хлороформа. Авторами установлено, что у детей, проживающих в условиях воздйствия токсикантов, имеющих гипокинетический тип нарушения функции билиарного тракта, достоверно увеличено среднегрупповое содержание в крови хрома и никеля относительно детей этой же группы, имеющих гиперкинетический тип билиарной дисфункции. В итоге определены причинно-следственные связи между ультразвуковыми показателями, характеризующими функцию билиарного тракта (процент сокращения желчного пузыря, объем выделенной желчи, объемный расход желчи, время максимального сокращения желчного пузыря) и содержанием хрома, никеля и хлороформа в крови.

Материалы статьи содержат данные об особенностях нарушений когнитивных функций и церебрального кровотока при вегетативных дистониях (ваготонии), ассоциированных с воздействием фенола и крезолов, у детей. Представлены результаты комплексного обследования, включающее данные врачебного осмотра, нейропсихологического тестирования, кардиоинтервалографии с функциональными пробами и допплерографии церебральных артерий с оценкой сосудистого тонуса и скоростных характеристик кровотока. Показано, что развитие нейровегетативных дисфункций происходит преимущественно по ваготоническому типу на фоне оксидативного стресса, развивающегося вследствие контаминации фенолом и крезолами. Диагностическая ценность комплексного подхода состоит в установлении ранних признаков дисфункций регуляторного и адаптационного звеньев ВНС, сочетающихся с когнитивными нарушениями, у детей, до развития у них хронической соматической патологии. Установлены статистически достоверные причинно-следственные связи между показателями церебрального кровотока, уровнем когнитивных нарушений и содержанием в крови фенола и крезолов, что позволило выделить основные патогенетические звенья формирования вегетативных дистоний, зависимых от воздействия изучаемых химических факторов.