• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.4
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• pp.195-198
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• 2014

Cavernous sinus thrombosis not only presents with constitutional symptoms including fever, pain and swelling but also with specific findings such as proptosis, chemosis, periorbital swelling, and cranial nerve palsies. It is known to occur secondary to the spread of paranasal sinus infections in the nose, ethmoidal and sphenoidal sinuses. However, paranasal sinus infection of dental origin is rare. The following is a case of cavernous sinus thrombosis due to the spread of an abscess in the buccal and pterygomandibular spaces via buccal mucosal laceration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.510-514
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• 2011

An intracapsular and pericapsular infection of the temporomandibular joint (TMJ) is rare. The invasion of bacteria into the joint space can occur through several routes. Among them, hematogenous spread is most common. This report describes three cases of abscess formation in the TMJ (intracapsular and pericapsular infection). The patients were treated with supportive care and surgical intervention (incision and drainage) under hospitalization, and their symptoms had improved. Pain of the TMJ is a typical symptom of temporomandibular joint disorders (TMD). On the other hand, an infection of the TMJ can also cause pain on the affected side, and can be misdiagnosed as routine TMD. Therefore, the possibility of an infection of the TMJ cavity should be considered when treating TMD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.4.1-4.4
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• 2020

Background: Odontogenic cysts associated with lower third molar are common. The prognosis for surgical treatment is relatively good. However, postoperative infection discourages the clinicians. Hence, we would like to investigate the factors associated with infection after surgical treatment of cysts associated with the mandibular third molar. Methods: We retrospectively reviewed the medical and radiographic records of 81 patients who were diagnosed with dentigerous cyst or odontogenic keratocyst and underwent cyst enucleation. The factors affecting postoperative infection were divided into host factor, treatment factor, and cystic lesion factor. To identify the factors associated with postoperative infection, we attempted to find out the variables with significant differences between the groups with and without infection. Results: A total of 81 patients (64 male and 17 female) were enrolled in this study. There was no statistical relationship about the postoperative infection between all variables (gender, smoking, diabetes mellitus, age, bone grafting, related tooth extraction, previous marsupialization or decompression, type of antibiotics, cortical perforation associated with cystic lesion, preoperative infection, preoperative cyst size). Conclusions: The results of this study suggest that it is not necessary to avoid bone grafts that are concerned about postoperative infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.25.1-25.5
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• 2019

Background: Brain abscess is a life-threatening condition that occurs due to complications during a neurosurgical procedure, direct cranial trauma, or the presence of local or distal infection. Infection in the oral cavity can also be considered a source of brain abscess. Case presentation: A 45-year-old male patient was transported with brain abscess in the subcortical white matter. Navigation-guided abscess aspiration and drainage was performed in the right mid-frontal lobe, but the symptoms continued to worsen after the procedure. A panoramic radiograph showed alveolar bone resorption around the maxillary molars. The compromised maxillary molars were extracted under local anesthesia, and antibiotics were applied based on findings from bacterial culture. A brain MRI confirmed that the three brain abscesses in the frontal lobe were reduced in size, and the patient's symptoms began to improve after the extractions. Conclusion: This is a rare case report about multiple uncontrolled brain abscesses treated by removal of infection through the extraction of maxillary molars with odontogenic infection. Untreated odontogenic infection can also be considered a cause of brain abscess. Therefore, it is necessary to recognize the possibility that untreated odontogenic infection can lead to serious systemic inflammatory diseases such as brain abscess. Through a multidisciplinary approach to diagnosis and treatment, physicians should be encouraged to consider odontogenic infections as a potential cause of brain abscesses.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.515-520
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• 1994

Herpes Zoster is an acute viral infection characterized by the appearance of vesicles that occur on the skin and mucous membrane along the pathway of an involved sensory nerve. Although Herpes zoster is usually as benign viral infection, complications may occur especially when cranial nerves are involved. There are few reports of bony and dental complications by Herpes Zoster infection, all of which were isolated in a single quadrant. These include devitalized teeth, abnormal development of permanent teeth, internal resoption and spontaneous exfoliation of teeth with osteonecrosis of the alveolar bone. No agreement has been reached concerning the pathogenesis of osteonecrosis and tooth exfoliation associated with herpes zoster infection. We recently experienced series of maxillary osteonecrosis and spontaneous teeth exfoliation in patients with Herpes Zoster infection and present two cases with review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.4
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• pp.322-328
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• 2005

Oral and maxillofacial infections are most commonly odontogenic in origin. The present study was implemented for patients with oral and maxillofacial infections in order to determine what differences were present in cultured bacteria, depending upon the different types of infection. For the present study, the epidemiological characteristics, the state of infection, and the results of the pus culture and antibiotic susceptibility tests were analyzed for the 159 cases where pus culture tests were performed. The patients were treated at the Oral and Maxillofacial Surgical Department of Chonnam National University Hospital during an 18-months period from March 2003 to August 2004. Among the total 159 pus culture specimens, bacteria were cultured in 111 cases (69.8%). In the 111 pus culture specimens, Streptococcus species, Neisseria species, and Staphylococcus species were cultured from 69 cases (51.1%), 21 cases (15.6%), and 15 cases (11.1%), respectively and were determined to be bacterial strains the predominant bacteria responsible for oral and maxillofacial infectious diseases. Twenty four cases (15.1%) among the 159 specimens showed mixed infections. The mostly isolated bacteria from each of the space abscess, dentoalveolar abscess, inflammatory cyst, and pericoronitis cases were the Viridans streptococci. There was little relevance between the type of infection and the type of cultured bacteria. Antibiotic susceptibility tests showed a high level of susceptibility to teicoplanin(100%), vancomycin(100%), chloramphenicol(96.4%), ofloxacin(88.3%), imipenem(83.3%), erythromycin(82.5%) and a low susceptibility to cefazolin(40.0%), oxacillin(44.7%), ampicillin(49.4%), penicillin(51.1%). These results indicate that there was no significant difference among the cultured bacteria depending on the type of infections and their susceptibility to cephalosporin and penicillin G was low.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.577-581
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• 2010

Descending necrotizing mediastinitis (DNM) is a complication of odontogenic or oropharyngeal infections that can spread to the mediastinum. Such infections is serious, leading to sepsis and frequently to death. Even in this era of antibiotics, the mortality rate associated with DNM is approximately 40%. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. Delayed diagnosis is the principal reason for the high mortality in DNM. Therefore, descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. We experienced a case of odontogenic infection followed by acute mediastinitis, so present now with the review of literatures.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.49.1-49.8
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• 2019

Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.5
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• pp.251-258
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• 2015

Objectives: This study was performed to evaluate the impact of glycosylated hemoglobin (HbA1c) level on characteristics and prognosis of maxillofacial fascial infection in diabetic patients. Materials and Methods: We reviewed the medical records of 72 patients (35 patients with HbA1c lower than 7.0% and 37 patients with HbA1c higher than 7.0%) diagnosed with maxillofacial fascial space infection and hospitalized for treatment at the Department of Oral and Maxillofacial Surgery in Dankook University Hospital (Cheonan, Korea) from January 2005 to February 2014. We compared demographics, parameters of glucoregulation (HbA1c), laboratory parameters of inflammation (white blood cell [WBC], C-reactive protein [CRP] count), type and number of involved spaces, type and number of antibiotics, period of hospitalization, number of surgical operations, need for tracheostomy, complications, computed tomography (CT), and microorganisms between the two groups. Results: Compared with the well-controlled diabetes mellitus (DM) group (HbA1c <7.0%), patients in the poorly-controlled (HbA1c ${\geq}7.0%$) DM group had the following characteristics: longer hospitalization periods, higher values of laboratory parameters of inflammation (WBC, CRP count) at the time of admission, higher number of antibiotics prescribed, more frequent complications, frequent deep neck space involvement, and distinctive main causative microorganisms. As the HbA1c level increases, hospitalization periods and incidence of complications increase gradually. Conclusion: This retrospective study suggests that regulation of DM significantly impacts maxillofacial fascial infection. Poorly controlled DM with high HbA1c level negatively influences the prognosis of infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.6
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• pp.580-587
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• 2006

Necrotizing fasciitis has been recognized as a potentially lethal and rapidly progressing infection. Necrotizing fasciitis of head and neck area is rare but fatal disease that should be prompt diagnosis and recognition. If not promptly recognized and treated, infection can spread into the deep spaces of the neck and compromise the airway. It may also spread into the mediastimum producing life threatening sepsis. In this report, we describe the treatment of 4 cases of necrotizing fasciitis of head and neck area and discuss diagnosis, treatment, complication and consideration with review of literatures.