Periostitis of the mandible. A case report and review of the literature.

Periostitis of the mandible has not been previously discussed in the otolaryngologic literature and only infrequently in the dental literature. It is characterized by a hard, painless, fixed mass overlying the mandible in a child or young adult. The etiology is usually an endosteal infection in the molar region with periosteal inflammation. Reactive new bone is deposited beneath the elevated periosteum, external to the outer cortex of the jaw, and separated from it by a layer of suppurative fluid. Treatment consists of removal of involved teeth and infected bone, drainage of the fluid pocked and appropriate antibiotics. Patients are followed with repeat X-rays and erythrocyte sedimentation rates. A case is presented and the world literature is reviewed. The otolaryngologist should be aware of this entity and include it in the differential diagnosis of any fixed jaw mass to avoid mistaking it for a more malignant process with unfortunate consequences.