Submental Flap Reconstruction for Mandibular Osteomyelitis in an Adolescent Patient With Osteopetrosis: A Case Report.
- 1Department of Clinical Pediatrics, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury in Olsztyn, Olsztyn, POL.
- 2Department of Maxillofacial, Reconstructive and Plastic Surgery, Head and Neck Surgery Clinic for Children and Young Adults, Regional Specialized Children's Hospital in Olsztyn, Olsztyn, POL.
Abstract
Osteopetrosis is a rare group of skeletal disorders characterized by impaired osteoclastic bone resorption and abnormal bone remodeling. Severe forms may result in bone marrow failure, extramedullary hematopoiesis, cranial nerve dysfunction, and skeletal complications. Mandibular osteomyelitis is a particularly challenging complication because impaired bone remodeling and compromised vascularity may contribute to persistent infection, osteonecrosis, and poor wound healing. We report the case of a 14-year-old girl with severe osteopetrosis, reported in her previous medical records as CLCN7-related, complicated by severe hematological abnormalities, hepatosplenomegaly, neurological complications, and chronic mandibular osteomyelitis with osteonecrosis. The patient underwent surgical removal of necrotic mandibular bone followed by reconstruction of the anterior floor-of-mouth soft-tissue defect using a submental flap. Preoperative computed tomography angiography confirmed patency of the relevant facial and submental vessels and supported the planned reconstruction. Given the patient's anemia, thrombocytopenia, malnutrition, and limited physiological reserve, a limited surgical approach was selected to avoid more extensive mandibular resection. Following surgery, significant postoperative airway edema required continued mechanical ventilation and pediatric intensive care unit management. After multidisciplinary postoperative care, successful extubation was achieved on the third postoperative day, followed by transfer to the maxillofacial surgical ward in a hemodynamically and respiratory stable condition with satisfactory early postoperative healing. This case highlights the challenges of managing mandibular osteomyelitis in patients with severe osteopetrosis and significant systemic disease. Individualized surgical planning and multidisciplinary perioperative management are essential in this setting. Submental flap reconstruction provided vascularized soft-tissue coverage in the immediate postoperative period while avoiding a more extensive reconstructive procedure.
Related
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- Social Determinants of Health and Dental Rehabilitation After Mandibular Reconstruction: A Scoping Review of an Evidence Gap
BibTeX
@article{matysek2026submental,
title = {{Submental Flap Reconstruction for Mandibular Osteomyelitis in an Adolescent Patient With Osteopetrosis: A Case Report.}},
author = {Jeremi Matysek and Dominika Lech and Robert Maksymowicz and Cyprian Straczek and Krzysztof Dowgierd},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.116923},
url = {https://europepmc.org/article/MED/42928932},
note = {CC BY},
}
RIS
TY - JOUR
TI - Submental Flap Reconstruction for Mandibular Osteomyelitis in an Adolescent Patient With Osteopetrosis: A Case Report.
AU - Jeremi Matysek
AU - Dominika Lech
AU - Robert Maksymowicz
AU - Cyprian Straczek
AU - Krzysztof Dowgierd
PY - 2026
DA - 2026/09/25
JO - Cureus
DO - 10.7759/cureus.116923
UR - https://europepmc.org/article/MED/42928932
AB - Osteopetrosis is a rare group of skeletal disorders characterized by impaired osteoclastic bone resorption and abnormal bone remodeling. Severe forms may result in bone marrow failure, extramedullary hematopoiesis, cranial nerve dysfunction, and skeletal complications. Mandibular osteomyelitis is a particularly challenging complication because impaired bone remodeling and compromised vascularity may contribute to persistent infection, osteonecrosis, and poor wound healing. We report the case of a 14-year-old girl with severe osteopetrosis, reported in her previous medical records as CLCN7-related, complicated by severe hematological abnormalities, hepatosplenomegaly, neurological complications, and chronic mandibular osteomyelitis with osteonecrosis. The patient underwent surgical removal of necrotic mandibular bone followed by reconstruction of the anterior floor-of-mouth soft-tissue defect using a submental flap. Preoperative computed tomography angiography confirmed patency of the relevant facial and submental vessels and supported the planned reconstruction. Given the patient's anemia, thrombocytopenia, malnutrition, and limited physiological reserve, a limited surgical approach was selected to avoid more extensive mandibular resection. Following surgery, significant postoperative airway edema required continued mechanical ventilation and pediatric intensive care unit management. After multidisciplinary postoperative care, successful extubation was achieved on the third postoperative day, followed by transfer to the maxillofacial surgical ward in a hemodynamically and respiratory stable condition with satisfactory early postoperative healing. This case highlights the challenges of managing mandibular osteomyelitis in patients with severe osteopetrosis and significant systemic disease. Individualized surgical planning and multidisciplinary perioperative management are essential in this setting. Submental flap reconstruction provided vascularized soft-tissue coverage in the immediate postoperative period while avoiding a more extensive reconstructive procedure.
SN - 2168-8184
ER -