Management of Wound Infection and Acute Bacterial Rhinosinusitis After Sinus Elevation Surgery: A Case Report

Sinus graft infection with consequent acute bacterial rhinosinusitis (ABRS) is a complication that can occur during the postoperative period following sinus augmentation surgery. A small group of bacteria appear to predominate in ABRS, and these bacteria are empirically susceptible to tetracycline antibiotics, barring the presence of resistant strains. Historically, clinicians have mixed tetracycline with various biomaterials or hydrated biomaterials in a dilute tetracycline solution in the treatment of periodontal disease and for ridge preservation/augmentation indications.

In the present case, a 39-year-old African-American male with sinus graft infection and signs and symptoms consistent with ABRS was successfully treated by removing the initial graft material, thoroughly debriding and irrigating the antrum, and placing a freeze-dried bone allograft hydrated in an aqueous tetracycline solution.

Given the typical bacteria present in ABRS, locally applied tetracycline may be useful prophylactically in sinus elevation surgery or as an adjunct in managing postoperative sinus graft infection.