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Use of tobramycin-impregnated antibiotic beads in frontal sinus osteomyelitis

Published online by Cambridge University Press:  04 January 2023

E Richards Open the ORCID record for E Richards [Opens in a new window] ,
N Qamar ,
P Naik  and
S Ahmed
E Richards*
Affiliation:
ENT Department, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
N Qamar
Affiliation:
ENT Department, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
P Naik
Affiliation:
ENT Department, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
S Ahmed
Affiliation:
ENT Department, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
*
Corresponding author: Dr E Richards, ENT Department, Queen Elizabeth Hospital Birmingham, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham B15 2PR, UK E-mail: emma.richards13@nhs.net
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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.

Keywords

OsteomyelitisFrontal SinusTobramycinAnti-Bacterial Agents
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 8 , August 2023 , pp. 934 - 937
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr E Richards takes responsibility for the integrity of the content of the paper

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