유아의 급성 상악골 골수염 2례

Acute maxillary osteomyelitis in infants which was first described by Rees(1847), is a rare condition in which the patient develops a massive osseus infection of the midface during the first 3 weeks after birth. A causative agent ( esp. Staphylococci, Streptococci, Pneumococci ) may become pathogenic and widespread after break of the mucosal barrier due to trauma or infection. The clinical picture is that of an acutely ill appearance with a unilateral swelling of the face and eye, a swollen gum and a purulent nasal discharge all on the same side.

We experienced 2 cases of acute maxillary osteomyelitis on Feb. and Apr. 1995. They were admitted to the department of Pediatrics due to fever, feeding difficulty, cheek swelling with redness, unilateral nasal discharge under the impression of dacryocystitis and maxillary sinusitis. They took antibiotics therapy but symptom did not improved. So they were transfered to our department. Physical examination revealed purulent unilateral nasal discharge and granulation tissue. In another case, fistula at medial canthus area and alveolar arch were noted.

After they underwent sequestrectomy and endoscopic sinus surgery with 0°, 2.7mm endoscopy, under general anesthesia, with adequate antibiotics therapy, their physical status were improved.