Surgical management of primary chronic osteomyelitis of the jaws in children: A prospective analysis of five cases and review of the literature

被引:27
作者
Theologie-Lygidakis N. [1 ,2 ]
Schoinohoriti O. [1 ]
Iatrou I. [1 ]
机构
[1] University Department of Oral and Maxillofacial Surgery, A. and P. Kyriakou Children's Hospital, Dental School, University of Athens, Athens
[2] Athens 11528
关键词
Children; Jaws; Primary chronic osteomyelitis; Surgical treatment;
D O I
10.1007/s10006-010-0248-3
中图分类号
学科分类号
摘要
Introduction: Primary chronic osteomyelitis (PCO) of the jaws is an uncommon non-suppurative inflammatory disease of unknown origin. Although the disease is not age-specific, only sparse cases with onset during childhood or adolescence have been reported in the literature. Purpose: This study seeks to present five cases of maxillofacial PCO in children and to evaluate the effectiveness of the applied therapeutic protocol. A review of the literature concerning diagnosis and treatment of PCO with special emphasis on surgical therapy is also performed. Patients and methods: Demographic data, clinical, radiographic and histopathologic findings, blood tests results, and the treatment protocol applied to five young patients suffering from PCO and referred to the Department of Oral and Maxillofacial Surgery at "A. & P. Kyriakou Children's Hospital" over the past 5 years are presented. Decortication and contouring of the affected bone were performed; antibiotics were administered for a short period of time and the patients remained under follow-up evaluation. Results: The posterior mandible was affected in four cases and the maxilla-zygomatic bone in one case. All patients showed remission of signs and symptoms after surgical treatment. The postsurgical clinical course was uneventful in all cases. However, recurrences have been noted, as reported in the literature. Conclusion: PCO of the jaws is a complex clinical entity, presenting both a diagnostic and therapeutic challenge, especially in young patients. Surgical treatment in conjunction with antibiotics and non-steroid anti-inflammatory drugs proved to be beneficial and to improve considerably the patients' quality of life. Nevertheless, exacerbation of the disease may appear and regular follow-up of the patients is required. © 2010 Springer-Verlag.
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页码:41 / 50
页数:9
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共 41 条
  • [1] Eyrich G.K.H., Baltensperger M.M., Bruder E., Graetz K.W., Primary chronic osteomyelitis in childhood and adolescence: a retrospective analysis of 11 cases and review of the literature, J Oral Maxillofac Surg, 61, pp. 561-573, (2003)
  • [2] Baltensperger M., Gratz K., Bruder E., Lebeda R., Makek M., Eyrich G., Is primary chronic osteomyelitis a uniform disease? Proposal of a classification based on a retrospective analysis of patients treated in the past 30 years, J Craniomaxillofac Surg, 32, pp. 43-50, (2004)
  • [3] Eyrich G.K.H., Harder C., Sailer H.F., Langenegger T., Bruder E., Michel B.A., Primary chronic osteomyelitis with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome, J Oral Pathol Med, 28, pp. 456-464, (1999)
  • [4] Hjorting-Hansen E., Decortication in treatment of osteomyelitis of the mandible, Oral Surg Oral Med Oral Pathol, 29, pp. 641-655, (1970)
  • [5] Groot R.H., van Merkesteyn J.P., Bras J., Diffuse sclerosing osteomyelitis and florid osseous dysplasia, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 81, pp. 333-342, (1996)
  • [6] Groot R.H., van Merkesteyn J.P., van Soest J.J., Bras J., Diffuse sclerosing osteomyelitis (chronic tendoperiostitis) of the mandible. An 11-year follow-up report, Oral Surg Oral Med Oral Pathol, 74, pp. 557-560, (1992)
  • [7] van Merkesteyn J.P., Groot R.H., Bras J., McCarroll R.S., Bakker D.J., Diffuse sclerosing osteomyelitis of the mandible: a new concept of its etiology, Oral Surg Oral Med Oral Pathol, 70, pp. 414-419, (1990)
  • [8] Eisenbud L., Miller J., Roberts I.L., Garré's proliferative periostitis occurring simultaneously in four quadrants of the jaws, Oral Surg Oral Med Oral Pathol, 51, pp. 172-178, (1981)
  • [9] Ellis D.J., Winslow J.R., Indovina A.A., Garré's osteomyelitis of the mandible. Report of a case, Oral Surg Oral Med Oral Pathol, 44, pp. 83-189, (1977)
  • [10] Bevin C.R., Inwards C.Y., Keller E.E., Surgical management of primary chronic osteomyelitis: a long-term retrospective analysis, J Oral Maxillofac Surg, 66, pp. 2073-2085, (2008)