구내 접근법에 의한 하악골 골수염의 치료에 대한 임상적 고찰

A clinical review on transoral approaches to treat osteomyelities of the mandible

Osteomyelitis of the mandible is a perplexing disease to both patients and surgeons because of curability, longterm period of treatment and functional and esthetic problems related to disease and/or surgical treatments. Classical extraoral approach for surgical treatment of osteomyelitis of the mandible has many advantages in surgical field, drainage and healing time etc, however, its resultant scar tissues and risk of facial nerve damages are sometimes difficult to use in patients who are afraid of esthetic damage of the face. This is a retrospective clinical study on osteomyelitis of the mandible treated by transoral approaches related to irevitable factors of patients. We reviewed 5 patients and the obtained results are as follows: 1. Primary closure with transoral decortication and saucerization gave a possibility of good healing process without any recurrence or complications in case of chronic osteomyelitis which had not active pus discharge. 2. Even though patient had severe osteomyelitis associated with comminuted fracture of the mandible and uncontrolled diabetic mellitus, we could obtain good results by transoral approaches. 3. Transoral approaches for surgical care of osteomyelitis of the mandible offered excellent cosmetic and functional results in all of our cases, however, proper selection of patients and antibiotics should be important.