An unusual case of osteomyelitis of the maxilla treated by radical surgery

Osteomyelitis of the orbital area is an unusual disease, particularly when the offending organism is Pseudomonas aeruginosa. A case of chronic osteomyelitis of the paranasal sinuses, ocular orbit, and complications including acute meningitis and brain abscess is reported in an 11-year-old child. After a 9 year course employing a variety of unsuccessful regimens the problem was satisfactorily managed by a combined medical-surgical approach. The program consisted of appropriate antibiotic agents, fibrinolytic enzymes, and radical surgery with preservation of the hard palate. The necessity for operation and the resultant cosmetic defect were discussed with the patient prior to operation, and this discussion resulted in a good emotional adjustment to the procedure.