Clinical observations of mandibular chronic osteomyelitis

combination therapy with decortication and intra-arterial infusion of antibiotics

Abstract

Mandibular chronic osteomyelitis with diffuse osteosclerosis is recognized as an intractable infectious disease. We employed decortication and intra-arterial infusion of antibiotics to treat 6 cases.
Decortication of the affected mandible was performed with retrograde catherization to the superficial temporal artery of the affected side with the patient under general anesthesia. Antibiotics, IPM/CS or FMOX, were given intra-arterially for 4 to 11 days. In addition, FMOX and PIPC were administered intravenously for 8 to 17 days. CT and MRI were performed postoperatively. Postoperative follow-up ranged from 1 year 6 months to 2 years 5 months.
Postoperative MRI showed that bone marrow signals recovered to nearly normal in 4 cases. High-signal areas of bone marrow and osteosclerotic changes remained in 2 cases, but showed improvement.
The results were satisfactory, without recurrence in any of the 6 cases.