Volume 19 Issue 2
Feb.  2021
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Article Navigation >  Chinese Journal of General Practice  > 2021  >  19(2): 232-235
WANG Yan, WANG Jing-xiao, GUO Qian-qian, CHEN Bin, LUO Jia, LYU Yi-min, ZHOU Chang-long. Clinical diagnosis, treatment, and imaging analysis of diffuse osteomyelitis of the maxilla[J]. Chinese Journal of General Practice, 2021, 19(2): 232-235. doi: 10.16766/j.cnki.issn.1674-4152.001775
Citation: WANG Yan, WANG Jing-xiao, GUO Qian-qian, CHEN Bin, LUO Jia, LYU Yi-min, ZHOU Chang-long. Clinical diagnosis, treatment, and imaging analysis of diffuse osteomyelitis of the maxilla[J]. Chinese Journal of General Practice, 2021, 19(2): 232-235. doi: 10.16766/j.cnki.issn.1674-4152.001775
shu

Clinical diagnosis, treatment, and imaging analysis of diffuse osteomyelitis of the maxilla

doi: 10.16766/j.cnki.issn.1674-4152.001775
  • 1.

    Department of Stomatology, Lihuili Hospital of Ningbo Medical Center, Ningbo, Zhejiang 315000, China

Funds:

 2017C33168

  • Received Date: 2020-04-11
    Available Online: 2022-02-19
    Abstract
  •   Objective  To investigate the clinical manifestations, imaging features, and treatment of diffuse osteomyelitis of the maxilla.  Methods  From January 2011 to March 2020, the clinical data and imaging features of three patients with diffuse osteomyelitis of the maxilla admitted to the Department of stomatology, Lihuili Hospital, Ningbo Medical Center were analysed retrospectively. Ten patients (6 males and 4 females, aged 7-79 years, average of 52.5 years) duration of 2.5 months-1 year, with an average of 4.8 months, including 1 with two phosphonic acid salts medication history, 4 with a history of diabetes, 1 with fungal infection history, 10 with the same pain with facial swelling and discharging mouth, 3 with fever, 7 with no obvious fever. All patients underwent CT examination to determine the condition of soft and hard tissues on the affected side. They were given cephalosporin anti-infection treatment before surgery, followed by maxillary osteomyelitis dead-bone curetomy (including maxillary sinus radical resection), and further followed by cephalosporin anti-infection treatment and hyperbolic oxygen treatment.  Results  The main clinical manifestations of the 10 patients were as follows: conscious side pain and discomfort, obvious facial swelling, excessive pus in the mouth, bone exposure, and obvious tenderness. The imaging findings were as follows: extensive patchy, uneven low-density shadow of the maxillary bone, bone destruction, local bone cortex discontinuity, gas density shadow in some areas, corresponding osteolysis destruction of the upper alveolar bone, swelling and accumulation of surrounding soft tissues. After treatment, the symptoms such as swelling and pain, pus discharge significantly improved without recurrence.  Conclusion  Imaging examination, especially CT, plays an important role in diagnosing diffuse osteomyelitis of the maxilla by guiding the treatment plan. Combined with medication, hyperbaric medicine, and surgery, this technique can achieve good results.

     

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