Osteomyelitis of the Craniofacial Skeleton

Abstract

Skull-based osteomyelitis, which is a true bony infection, originates from a chronic, inadequately treated infection. Because of the complex craniofacial skeletal anatomy and associated aesthetic concerns, osteomyelitis of the craniofacial skeleton must be uniquely managed and is more difficult to treat than osteomyelitis of other bones of the body. It is thought that osteomyelitis is decreasing in prevalence due to broadspectrum antibiotic treatment; however, it still remains a challenging clinical entity in developing countries and lower socioeconomic areas.

Chronic Osteomyelitis of the Mandible: Diagnosis and Management—An Institution's Experience Over 7 Years

“…Its clinical course is described as chronic pain and inflammation with periods of exacerbation. 4 Severe complications such as pathologic fractures and nerve deficits are commonly reported. Management of chronic osteomyelitis poses a significant challenge due to anatomic location and polymicrobial nature of the disease as well as the physiologic status of the patients.…”

“…Surgical interventions of varying degree are usually indicated. 4 Even with proper management; however, treatment courses can become remarkably expensive with long hospital stays and prolonged antibiotic administration. 5 The wide variety of classification schemes and treatment approaches for the management of chronic osteomyelitis in the current literature based on its clinical course, pathological and/or radiological features and/or the pathogenesis inevitably leads to confusion and hinders comparative studies.…”

Chronic Skull Osteomyelitis following Skin Graft: A Case Report and Literature Review

“…Patients with chronic OM rarely appear ill, but our patient was febrile and did appear ill. With special attention to spiral head CTs, the penetration of the infection into the brain's parenchyma and other areas of the skull was identifiable. This is a very important point in outstanding our report (5)(6)(7)(8).…”

Chronic maxillary osteomyelitis secondary to chronic maxillary sinusitis in non-immunocompromised patient – a rare case report and its management

“…Major predisposing factor for osteomyelitis is systemic condition that alters the host resistance due to immunosuppression [12]. Examples of systemic conditions that decreases host defense are diabetes, autoimmune diseases, agranulocytosis, leukemia, a nemia, nut rit iona l def iciencies, cancer, chemotherapy, radiotherapy, alcohol and tobacco consumption, viral fevers, osteoporosis, osteopectoris, Paget's disease, FCOD, and so forth that decreases the vascularity of bone and therefore cause predisposition to the infection [1,4,9]. However, the predisposing factors for osteomyelitis of maxilla also includes traumatic conditions following the injury or surgery teeth, antrum or mouth, odontogenic infections and rhinogenic causes along with systemic immunosuppression [10,13].…”

“…Conventional radiographs, CT, MRI, SPECT scans can be used for the detection of the lesion [9]. Radiographically spotty osteolytic changes are more frequently observed in chronic osteomyelitis of the maxilla while osteosclerosis is rare [13].…”