Johnson Thomas M, Lincicum Adam R
United States Army Advanced Education Program in Periodontics, Fort Gordon, GA.
Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, GA.
Clin Adv Periodontics. 2018 Jun;8(2):54-60. doi: 10.1902/cap.2017.170039. Epub 2018 Feb 21.
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.
鼻窦移植感染并继发急性细菌性鼻窦炎(ABRS)是鼻窦增高手术后可能出现的一种并发症。一小部分细菌似乎在ABRS中占主导地位,并且在不存在耐药菌株的情况下,这些细菌经验性地对四环素类抗生素敏感。从历史上看,临床医生在治疗牙周疾病以及用于牙槽嵴保存/增高适应症时,会将四环素与各种生物材料或水合生物材料混合在稀四环素溶液中。
在本病例中,一名39岁患有鼻窦移植感染且有与ABRS相符的体征和症状的非裔美国男性,通过移除初始移植材料、彻底清创和冲洗上颌窦,并植入在四环素水溶液中水合的冻干同种异体骨而成功治愈。
鉴于ABRS中存在的典型细菌,局部应用四环素在鼻窦提升手术中可能具有预防性作用,或作为处理术后鼻窦移植感染的辅助手段。