Combination of Surgical and Medical Management of Cranial Osteomyelitis

Abstract

One definition of the term "osteomyelitis" is inflammation of the bone and bone marrow. In spite of its rarity, cranial osteomyelitis may be fatal if not diagnosed and treated quickly. Aim of work: Outcome of combination of surgical and medical management of cranial osteomyelitis. Patients and methods: A retrospectives analysis study includes 40 patients with cranial osteomyelitis. All the patients had conducted a standard data collection including demographics data, comorbidities and predisposing factors, full medical history along with complete physical examinations, outcomes of pre- and post-operative imaging techniques including computed tomography (CT) and magnetic resonance imaging (MRI), as well as microbiological and histological analyses. The cases were separated into 2 groups (cryptogenic & non-cryptogenic). The study discusses the treatment of cranial osteomyelitis and the effect of medications in the beginning of the treatment followed by surgical intervention. Results: The most common risk factor of our study was smoking, observed in 30 (75%) of patients, while diabetes was the second, observed in 23(57.5%). Staphylococcus aureus represents the most common organism of analyzed patient (n=50) (41.7%), Mycobacterium TB. was the second pathogen identified (n=33) (27.5%). Successful treatment of cranial osteomyelitis was achieved in 97.5% starting with broad-spectrum antibiotic, followed by surgery. while unsuccessful treatment was found in 2.5%. with the same protocol. Conclusion: Complications from cranial osteomyelitis have decreased with the advent of broad-spectrum antibiotics and the development of advanced neurosurgical techniques. Our results demonstrate that empirical systemic antimicrobial therapy, and management of predisposing factors, Treatment of cranial osteomyelitis consists of antibiotics, followed by strict surgical debridement