Sternoclavicular joint osteomyelitis following head and neck surgery.

OBJECTIVES/HYPOTHESIS: To review all reported cases of sternoclavicular joint (SCJ) osteomyelitis following head and neck surgery.

STUDY

DESIGN

Retrospective case review.

METHODS

PubMed search and one additional case from our institution.

RESULTS

Twelve cases were reviewed, and the following recommendations are suggested: risk factors for SCJ osteomyelitis should be identified; early and prompt diagnosis of SCJ osteomyelitis is warranted; tracheostoma care and careful examination of the skin should not be neglected; meticulous screening for cancer recurrence is imperative; if SCJ infection is suspected, cancer recurrence must be ruled out with biopsies; and surgical debridement is considered the gold standard of treatment. Administration of newer-generation antibiotics is a reasonable choice when the infection is detected early, as is maintaining a low threshold for surgical treatment if disease persists or progresses.

CONCLUSIONS

Osteomyelitis of the SCJ following head and neck surgery is uncommon and must be distinguished from malignancy with biopsies. Early diagnosis and treatment are imperative. Laryngoscope, 2010.