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Chronic nonbacterial osteomyelitis

Winters, Ryan; Tatum, Sherard A. III

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2014 - Volume 22 - Issue 4 - p 332–335
doi: 10.1097/MOO.0000000000000071
MAXILLOFACIAL SURGERY: Edited by Sherard A. Tatum

Purpose of review Chronic nonbacterial osteomyelitis encompasses a spectrum of sterile bony inflammatory lesions that are incompletely understood and not well known in the otolaryngology community.

Recent findings Current research is investigating the underlying immunologic mechanisms postulated to be responsible for chronic nonbacterial osteomyelitis. Disruption in the innate balance between proinflammatory and anti-inflammatory cytokines is currently felt to be responsible, with several specific pathways identified as potential targets for treatment. Additionally, Propionibacterium sp. and other infectious organisms are now felt to be triggers of inflammation, rather than true causative agents.

Summary Nonsteroidal anti-inflammatory medications remain the first-line treatment for this condition. Additional medical therapy, such as glucocorticoids, can be indicated in refractory cases. Surgical options are available for recalcitrant situations, although the potential for recurrence after surgery remains, as the underlying mechanism has not been addressed with surgery alone.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York, USA

Correspondence to Sherard A. Tatum III, MD, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, 450 E. Adams St., Syracuse, NY 13202, USA. Tel: +1 315 464 4636; fax: +1 315 464 7282; e-mail: tatums@upstate.edu

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