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Chronic suppurative osteomyelitis of the mandible: case report
S C Yeoh1, S MacMahon, M Schifter
1Oral Medicine/Oral Pathology, Department of Oral Medical and Surgical Sciences, Westmead Centre for Oral Health, Westmead Hospital, Westmead, NSW. syeo0600@mail.usyd.edu.au
Background:
Osteomyelitis of the maxillofacial skeleton is rare in developed countries such as Australia. This case report describes the successful surgical treatment of chronic suppurative osteomyelitis (CSO) of the mandible in a 75 year old man. The precipitant factor was thought to be a retained tooth root in the (right) posterior body of the mandible.
Methods:
Treatment included a pre-surgical course of antibiotics (clindamycin 300mg, p.o. q.i.d. for two weeks) followed by removal of the retained root, surgical débridement of the affected bone, the intra-oral draining sinus, and resection of the cutaneous sinus tract. Specimens were taken for bacterial cultures and antibiotic sensitivity testing, and the resected tissue sent for histopathological review.
Results:
On clinical and radiographic review at three months, the patient was well, completely symptom free and the osteomyelitis had fully resolved.
Conclusion:
This case report demonstrates the typical features of CSO. The combination of antibiotic therapy and surgical débridement was effective in the treatment of chronic suppurative osteomyelitis of the mandible utilizing intravenous sedation, and so averting the need for a general anaesthetic.