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Osteomyelitis in the head and neck.

Kishore Chandra Prasad¹, Sampath Chandra Prasad, Neela Mouli

¹Department of Otolaryngology - Head & Neck Surgery, Kasturba Medical College, Mangalore, India. kishorecprasad@yahoo.com

Acta Oto-Laryngologica

|March 17, 2007

Summary

Osteomyelitis can affect any head and neck bone, with the mandible being most common. Treatment varies from antibiotics for acute cases to radical surgery for osteoradionecrosis (ORN).

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Area of Science:

Medical research
Head and neck surgery
Infectious diseases

Background:

Osteomyelitis in head and neck bones is rare but complex due to anatomy and aesthetics.
Predisposing conditions significantly influence the occurrence and management of head and neck osteomyelitis.

Purpose of the Study:

To analyze the behavior and management of osteomyelitis in head and neck bones.
To evaluate diagnostic tools and treatment strategies for head and neck osteomyelitis.

Main Methods:

Retrospective review of 84 head and neck osteomyelitis cases over 10 years.
Investigations included pus culture, antibiotic sensitivity, and radiology.
Treatment strategies differentiated between acute (medical) and chronic (surgical) cases.

Main Results:

The mandible was the most frequently affected bone, followed by the frontal bone and cervical spine.
Chronic osteomyelitis (89%) was more common than acute (11%).
Osteoradionecrosis (ORN) was a leading cause of mandibular osteomyelitis (41%), while chronic sinusitis predominated in frontal bone cases (100%). Tuberculosis and malignancy were key factors in cervical spine osteomyelitis.

Conclusions:

All facial skeleton and spine bones are susceptible to osteomyelitis.
Radiological tools are adequate for diagnosis.
Treatment requires conservative resection, except for ORN, which necessitates more radical surgical intervention.