Use of tobramycin-impregnated antibiotic beads in frontal sinus osteomyelitis.
Richards, E Qamar, N Naik, P Ahmed, S
Richards, E
Qamar, N
Naik, P
Ahmed, S
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Publication date
2023-01-04
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Abstract
Objective
Osteomyelitis of the frontal bone is a rare but devastating complication of frontal sinusitis. Treatment involves aggressive surgery to remove all sequestra in combination with long-term antibiotic therapy. However, systemic antibiotics may struggle to penetrate any remaining infection in devascularised areas, and the morbidity associated with surgical resection of some areas of the skull base is too high. In contrast, locally implanted antibiotics provide a reliable, high concentration of treatment to these areas while also minimising potential systemic side effects. The clinical application of tobramycin beads has primarily been used in orthopaedics as an adjunct to the treatment of tibial osteomyelitis or prosthetic joint infection.
Case report
To the best of the authors' knowledge, the two cases discussed here represent the first use of tobramycin antibiotic beads in frontal sinus osteomyelitis secondary to chronic rhinosinusitis.
Conclusion
These cases show promising use of tobramycin beads in recalcitrant frontal osteomyelitis.
Citation
Richards E, Qamar N, Naik P, Ahmed S. Use of tobramycin-impregnated antibiotic beads in frontal sinus osteomyelitis. J Laryngol Otol. 2023 Aug;137(8):934-937. doi: 10.1017/S0022215122002511. Epub 2023 Jan 4.
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Article