Osteomyelitis of the skull bones in post COVID-19 patients

The new coronavirus infection caused by the SARS-CoV-2 virus has become one of the deadliest pandemics of the last century. It is now known that COVID-19 leads to microvascular and macrovascular pathophysiological changes, causing many extrapulmonary complications. They occur even against the background of adequately conducted etiotropic and pathogenetic therapy. This is associated with several factors: an imbalance in the synthesis of inflammatory, anti-inflammatory, immunoregulatory cytokines and chemokines, inflammatory markers, macrophage activation. So, in 2020, otolaryngologists, maxillofacial surgeons and neurosurgeons around the world faced a complication of COVID-19, manifested by the development of necrosis of the nasal mucosa, middle and lower turbinates, hard palate mucosa destruction of the walls of the maxillary, frontal sinuses, bottom orbit, frontal bones.

MATERIAL AND METhODS: In the clinic of the Department of Neurosurgery and cranio-facial surgery of the RMANPE — hospital named after F. I. Inozemtsev, 20 patients with osteomyelitis of the maxilla, zygomatic, and ethmoid bones were treated in 2021, 2022. Subsequently, osteomyelitis of the cranial bones was diagnosed in 2 patients. They required craniectomy with excision of osteomyelitic altered frontal, parietal and temporal bones.

RESULTS: Patients were discharged from the hospital without intracranial infection complications. Reconstructive interventions to restore the tightness of the cranial cavity are planned no earlier than 1 year after discharge from the hospital.

CONCLUSION: Complications after COVID-19 require careful analysis. The pathogenesis of the formation of osteomyelitis of the skull bones has not been fully elucidated, correction of conservative pathogenetic therapy in order to reduce purulent complications.

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