M. Said 1, I. M. Kashbur 2, S. Fahmy 2, M. E1-Shikh 1
1-Faculty of Dentistry, Al Arab Medical University, Benghazi, G.S.P.L.A.J. 2-Department of Microbiology, Faculty of Medicine, Al Arab Medical University, Benghazi, G.S.P.L.A.J.
Garyounis Medical Journal Vol.16, No.1-2. January/July 1993:52-62
Thirty nine cases with extra oral sinuses, due to dental infection, were studied clinically and bacteriologically. The incidence of extra oral sinus was found to be (0.80%) of all cases attending with oral infection over one year. Males were more affected than females by the ratio 5:3, the most common were dental caries, periapical Infections and remaining roots, impacted lower third molar, osteomyelitis, fracture mandible, infected periodontal cysts, infected den tigerous cysts, osteoradionecrosis. Management of such conditions started by clinical examination, bacteriological examination for the detection of pathogens and the determination of their antibiotic sensitivity.
Seventy eight isolates were found in the specimens from 39 cases of extra oral sinuses that belong to 14 genera. Aerobes and facultative anaerobes formed 53% of all isolates, with Streptococcus viridans the most common isolates (35.9%). Anaerobes were isolated from 47% of cases with Bacteroides spp. commonest. About half the cases showed mixed infections. Antibiotic susceptibility tests showed that in aerobic infections, Ampicillin, either alone or with Cloxacillin, while in mixed infections, Ampicilin with Metronidazole,and in anaerobic infections Metronidazole, were the most effective regimens used. Erythromycin was the second choice to Ampicillin in Penicillin-sensitive patients.
However, the main treatment of such patients depended on surgical intervention to remove the predisposing cause and to excise the sinus tract, followed by the antibiotic indicated by sensitivity tests on the isolated organisms. No recurrences were seen in all 39 cases which were thus managed up to 6 months after.
Keywords: Extra-Oral Sinuses : A Clinical and Microbiological Study from Benghazi