CLINICAL AND LABORATORY ANALYSIS OF PURULENT-NECROTIC COMPLICATIONS OF THE MAXILLOFACIAL REGION IN PATIENTS WITH SYSTEMIC VASCULITIDES

Abstract

Abstract. Background. Systemic vasculitides are heterogeneous inflammatory disorders of blood vessels that may involve the oral cavity, upper aerodigestive tract, paranasal sinuses, and maxillofacial tissues. In clinical practice, purulent-necrotic lesions of the maxillofacial region in these patients frequently mimic odontogenic infection, chronic osteomyelitis, or isolated soft-tissue inflammation, which may delay the diagnosis of the underlying systemic disease. Objective. To analyze the clinical and laboratory features of purulent-necrotic complications of the maxillofacial region in patients with systemic vasculitides and to identify the major indicators associated with severe local tissue destruction. Materials and methods. A retrospective-prospective clinical study was conducted at the multidisciplinary clinic of Tashkent State Medical University. The study included 120 patients with systemic vasculitis and purulent-necrotic lesions of the maxillofacial region. Clinical examination, complete blood count, ESR, C-reactive protein, fibrinogen, biochemical tests, coagulation parameters, ANCA testing, computed tomography of the maxillofacial region and paranasal sinuses, and histopathological verification when indicated were analyzed. Results. Pain, facial soft-tissue swelling, mucosal ulceration, purulent discharge, necrotic soft-tissue defects, and alveolar bone involvement were the most common local manifestations. Laboratory analysis demonstrated inflammatory activation, including leukocytosis, neutrophilia, elevated ESR and C-reactive protein, as well as anemia and hypoalbuminemia in a substantial proportion of patients. Positive ANCA status, elevated CRP, and radiologic bone destruction were associated with a more severe local course and greater need for combined conservative-surgical management.