Sternoclavicular joint osteomyelitis following head and neck surgery

Laryngoscope. 2010 May;120(5):920-3. doi: 10.1002/lary.20849.

Abstract

Objectives/hypothesis: To review all reported cases of sternoclavicular joint (SCJ) osteomyelitis following head and neck surgery.

Study design: Retrospective case review.

Methods: PubMed search and one additional case from our institution.

Results: Twelve cases were reviewed, and the following recommendations are suggested: risk factors for SCJ osteomyelitis should be identified; early and prompt diagnosis of SCJ osteomyelitis is warranted; tracheostoma care and careful examination of the skin should not be neglected; meticulous screening for cancer recurrence is imperative; if SCJ infection is suspected, cancer recurrence must be ruled out with biopsies; and surgical debridement is considered the gold standard of treatment. Administration of newer-generation antibiotics is a reasonable choice when the infection is detected early, as is maintaining a low threshold for surgical treatment if disease persists or progresses.

Conclusions: Osteomyelitis of the SCJ following head and neck surgery is uncommon and must be distinguished from malignancy with biopsies. Early diagnosis and treatment are imperative. Laryngoscope, 2010.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Airway Obstruction / pathology
  • Airway Obstruction / surgery
  • Anti-Bacterial Agents / administration & dosage
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Glottis / radiation effects
  • Glottis / surgery
  • Humans
  • Infusions, Intravenous
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery
  • Laryngectomy
  • Male
  • Middle Aged
  • Neck Dissection
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / surgery
  • Otorhinolaryngologic Diseases / surgery*
  • Otorhinolaryngologic Neoplasms / radiotherapy
  • Otorhinolaryngologic Neoplasms / surgery*
  • Otorhinolaryngologic Surgical Procedures*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / surgery
  • Radiotherapy, Adjuvant
  • Radiotherapy, Conformal
  • Reoperation
  • Retrospective Studies
  • Risk Factors
  • Sternoclavicular Joint* / surgery
  • Tracheostomy

Substances

  • Anti-Bacterial Agents