ĐIỀU TRỊ PHẪU THUẬT VIÊM XƯƠNG SỌ MẶT TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Objective: To evaluate the clinical symptoms, causes, and treatment outcomes of 53 cases of necrotizing osteomyelitis at Cho Ray Hospital after the Covid-19 pandemic.

Subjects and methods: The research method was a prospective study of 53 patients: 25 males (47%) and 28 females (53%) with necrotizing osteomyelitis of the craniofacial region at the Department of Otolaryngology, Cho Ray Hospital from August 2021 to August 2023. The main clinical symptoms were persistent dull pain in the face and skull, pus fistule to the skin, maxillary bone mobility, necrotizing and perforation of the palatal bone. Most of patients had concomitant diabetes mellitus and in an unstable upon admission.

Surgery aimed at removing pathological bone and draining abscesses was performed in 49/53 cases using external, endoscopic, or combined approaches. 27 cases used a single surgical approach, 19 cases used two surgical approaches, and 3 cases used three surgical approaches in combination with antibiotics and antifungals. The minimum postoperative follow-up period was one year with no deaths patient.

Results: Except for the first 4 cases that did not undergo surgery and resulted in death. The remaining 49 cases have undergone surgery, have had good results  and were discharged from the hospital.

Conclusion: Necrotizing osteomyelitis is associated with COVID-19, particularly common in individuals with diabetes and weakened immune systems. The condition is easily overlooked due to confusion with common sinusitis. Surgical removal of the necrotic bone combined with medical and antifungal medication treatment yields good results.