MANAGEMENT OF MAXILLARY OSTEOMYELITIS IN PATIENTS WITH UNCONTROLLED DIABETES AND RAMSEY HUNT SYNDROME: A RARE CASE

Osteomyelitis is an infectious disease which occurs in jaws and one of the main factors in its aggravation is the impairment of microcirculation. Microangiopathy that develops in long term uncontrolled diabetes patients without predisposing factors is thought to change the course of osteomyelitis in those patients. It is aimed to improve recovery by controlling diabetes in this case report. The patient with diabetes referred to our clinic with swelling and pain at the right maxillary region. In the clinical examination, the right side of the maxilla was mobile. The biopsy result was osteomyelitis. Treatment plan was the excision of jawbone lesions and subsequent hyperbaric oxygen therapy. Diabetic control is important to reduce the risk of osteomyelitis in patients with uncontrolled diabetes. In the present case, treatment of osteomyelitis related to uncontrolled diabetes with surgery and hyperbaric oxygen therapy was demonstrated.

KONTROLSÜZ DİYABET VE RAMSEY HUNT SENDROMLU HASTADA MAKSİLLER OSTEOMİYELİT TEDAVİSİ: NADİR BİR OLGU

Osteomyelit kemik iliğinin enfektif hastalığıdır. Osteomyelitin şiddetini arttıran faktörlerden birisi kemik içi mikrosirkülasyonun bozulmasıdır. Uzun süreli kontrolsüz diabeti olan hastalarda gelişen mikroanjiyopatinin osteomyelitin seyrini olumsuz yönde değiştirdiği düşünülmektedir. Bu olgu sunumunda uzun süredir kontrolsüz diabeti olan hastada gelişen maksiller osteomyelitin tedavisi sunulmuştur. Kliniğimize sağ üst çenede ağrı ve şişlik şikayeti ile başvuran hastanın yapılan ağız içi klinik muayenesinde sağ maksillanın bütün olarak hareketli olduğu görülmüştür. İnsizyonel biopsi sonucu osteomyelit olarak raporlanmıştır. Hastaya kombine antibiyoterapi başlandıktan sonra glisemik regülasyonun sağlanması için endokrinoloji konsültasyonu yapılmıştır. Genel anestezi altında nekrotik alanların eksizyonu ve sonrasında hiperbarik oksijen tedavisi uygulanmıştır. Kontrolsüz diyabetli hastalarda osteomiyelit riskini azaltmak için diyabetik kontrol önemlidir. Bu olguda kontrolsüz diyabet ile ilişkili osteomiyelitin klinik özellikleri, cerrahisi ve ek olarak hiperbarik oksijen terapisi ile tedavisi sunulmuştur.

Kaynakça

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