Baur Dale A, Altay Mehmet Ali, Flores-Hidalgo Andres, Ort Yirae, Quereshy Faisal A
Associate Professor and Chair, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
Doctor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey; currently Research Fellow, Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, OH.
J Oral Maxillofac Surg. 2015 Apr;73(4):655-65. doi: 10.1016/j.joms.2014.10.017. Epub 2014 Nov 21.
The objective of this study was to retrospectively evaluate and report the associated factors with the diagnosis and management of 24 patients with chronic osteomyelitis of the mandible seen at the authors' institution during the past several years.
Only cases of chronic osteomyelitis of the mandible not associated with antiresorptive medications or radiotherapy to the maxillofacial region were included in the study. After confirmation of the diagnosis, initial clinical and radiologic findings, treatment approach, and outcome were evaluated for each patient. Fourteen male and 10 female patients (average age, 53.75 yr; range, 22 to 83 yr) were included.
The peak incidence of the disease was recorded in the fifth and sixth decades of life. An uneventful healing was observed in 20 patients (83.3%). One of 18 patients (5.5%) who underwent segmental resections developed a secondary infection and was managed with intravenously administered antibiotics. Three of 6 patients (50%) who were treated with marginal resections remained symptomatic after surgery.
Independent of the cause and presentation of the disease, complete resolution of the infection should be the main focus of management in patients with chronic osteomyelitis of the mandible, and findings of this retrospective study indicate that a conservative surgical approach is more likely to result in a less than ideal outcome.
本研究的目的是回顾性评估并报告过去几年在作者所在机构就诊的24例下颌骨慢性骨髓炎患者的诊断及治疗相关因素。
本研究仅纳入与抗吸收药物或颌面区域放疗无关的下颌骨慢性骨髓炎病例。确诊后，对每位患者的初始临床和影像学表现、治疗方法及结果进行评估。纳入14例男性和10例女性患者（平均年龄53.75岁；范围22至83岁）。
该疾病的发病高峰出现在50至60岁。20例患者（83.3%）实现顺利愈合。18例行节段性切除的患者中有1例（5.5%）发生继发感染，经静脉使用抗生素治疗。6例行边缘性切除的患者中有3例（50%）术后仍有症状。
无论病因及表现如何，感染的彻底消除应是下颌骨慢性骨髓炎患者治疗的主要重点，而这项回顾性研究结果表明，保守手术方法更有可能导致不理想的治疗结果。
