Sun Hai-Jiang, Xue Lei, Wu Chuan-Bin, Zhou Qing
Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University, Liaoning Institute of Dental Research, Heping District, Shenyang, China.
J Craniofac Surg. 2016 Nov;27(8):e728-e730. doi: 10.1097/SCS.0000000000003048.
Osteopetrosis represents a heterogeneous group of rare, hereditary bone disorders with variable clinical features, and an increase in bone density. Osteomyelitis of the jaws is a significant complication of osteopetrosis. In this article, a reported patient with osteopetrosis complicated by osteomyelitis of the mandible was examined. The patient was treated with intravenous antibiotic therapy, debridement of necrotic bone and hyperbaric oxygen therapy; in addition, the authors attempted to implant the calcium sulfate and vancomycin to reconstruct the bone defect. The patient demonstrated satisfactory healing, and no recurrence of osteomyelitis was observed during the 6-month follow-up period. The treatment of osteopetrosis complicated by osteomyelitis of the mandible is difficult. The treatment of osteopetrosis complicated by osteomyelitis is controversial. The authors recommend the following sequential treatment of osteopetrosis complicated by osteomyelitis of the mandible: systemic antibiotic therapy and hyperbaric oxygen therapy before and after surgery; debridement of the necrotic bone; sufficient periosteal coverage and adequate soft tissue to cover the wound; implantation with calcium sulfate and vancomycin to reconstruct the bone defect as much as possible, which may be helpful in treating the disease.
骨质石化症是一组罕见的遗传性骨病，临床特征各异，骨密度增加。颌骨骨髓炎是骨质石化症的一种重要并发症。本文对1例并发下颌骨骨髓炎的骨质石化症患者进行了检查。该患者接受了静脉抗生素治疗、坏死骨清创术和高压氧治疗；此外，作者尝试植入硫酸钙和万古霉素以重建骨缺损。患者愈合情况良好，在6个月的随访期内未观察到骨髓炎复发。下颌骨骨髓炎并发骨质石化症的治疗较为困难。骨髓炎并发骨质石化症的治疗存在争议。作者推荐以下针对下颌骨骨髓炎并发骨质石化症的序贯治疗方法：手术前后进行全身抗生素治疗和高压氧治疗；坏死骨清创术；充分的骨膜覆盖和足够的软组织覆盖伤口；尽可能植入硫酸钙和万古霉素以重建骨缺损，这可能有助于治疗该疾病。
