Dental and Medical Problems
2015, vol. 52, nr 3, July-September, p. 351–355
Publication type: clinical case
Osteomyelitis After Orthognathic Surgery – a Very Rare Case Report After Bilateral Sagittal Split Osteotomy in the Mandible
Zapalenie kości po zabiegu chirurgii ortognatycznej – rzadkie powikłanie po strzałkowym rozszczepieniu trzonu żuchwy
1 Department of Maxillo-Facial Surgery, Wroclaw Medical University, Wrocław, Poland
Many complications are well known after orthognathic surgery. Osteomyelitis (OM) present in the facial bone skeleton is a somewhat uncommon finding; however its occurrence might vary because of many co-existing disorders and diseases. The early and late outcomes of most known surgical complications are predictable and mostly easy to treat. Often the multidisciplinary treatment and diagnosis of rare complications is important. Osteomyelitis (OM) is a very rare complication after surgery. In a very short time just after surgery the first symptoms start to occur. Quite often without any direct symptoms, it might be misdiagnosed as other postsurgical complications. After a short period of time when the bone starts to be affected, a quick, direct therapeutic approach needs to be performed. Accurate microbiological scrubs are very important and should be repeated in order to improve direct antibiotic usage. Intravenous antibiotics and long-term hyperbaric oxygen therapy seems to be the treatment of choice in the treatment of this condition. We present a rare case of osteomyelitis in a 46-year-old patient after two jaw orthognathic surgery in the left mandible basis after bilateral sagittal split osteotomy (BSSO).
orthognathic surgery, osteomyelitis, bilateral sagittal split osteotomy
chirurgia ortognatyczna, zapalenie kości szczęk, strzałkowe rozszczepienie trzonu i gałęzi żuchwy
- Chang P.C., Fischbein N.J., Holliday R.A.: Central skull base osteomyelitis in patients without otitis externa: imaging findings. AJNR Am. J. Neuroradiol. 2003, 24, 1310–1316.
- Salman S., Young M., Van Sickels J.E.: Osteomyelitis after bilateral sagittal split osteotomy: case report and a review of the management. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontics 2011, 111, 442–448.
- An C.H., An S.Y., Choi B.R., Huh K.H., Heo M.S., Yi W.J., Lee S.S., Choi S.C.: Hard and soft tissue changes of osteomyelitis of the jaws on CT images. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 2012, 114, 118–126.
- Bolouri C., Merwald M., Huellner M.W., Veit-Haibach P., Kuttenberger J., Pérez-Lago M., Seifert B., Strobel K.: Performance of orthopantomography, planar scintigraphy, CT alone and SPECT/CT in patients with suspected osteomyelitis of the jaw. Eur. J. Nucl Med. Mol Imaging. 2013, 40, 411–417.
- Schulze D., Blessmann M., Pohlenz P., Wagner KW., Heiland M.: Diagnostic criteria for the detection of mandibular osteomyelitis using cone-beam computed tomography. Dentomaxillofac. Radiol. 2006, 35, 232–235.
- Pincus D.J., Armstrong M.B., Thaller S.R.: Osteomyelitis of the craniofacial skeleton. Sem. Plas. Surg. 2009, 23, 1–5.
- Valentini V., Cassoni A., Marianetti T.M.: Reconstruction of craniofacial bony defects using autogenous bone grafts: a retrospective study on 233 patients. J. Craniofac. Surg. 2007, 18, 953–958.