What happens if infection spreads to jaw bone?

Hi doctor,

My mother was admitted to the hospital with the added symptoms. She has been on antibiotics for a week. Also, a drain was placed in the face to get rid of the pus. The doctor had concerns about her air supply being compromised. This doctor is an ENT (Otolaryngologist) specialist, not an oral surgeon, and he is now saying that her jawbone must be removed due to infection. Is this a normal treatment after a week of antibiotics?

Thank you.

Hi doctor,

Thank you for your answer.

I have attached some of the files associated with my mother's case. The ENT doctor wants to do the surgery later today. Our family will helpfully be able to speak with this doctor later today. He does not seem to want to speak with us, which concerns me greatly. However, I would like to have some questions for him. I am concerned that an oral surgeon was not called in or consulted in this case. For the infection control doctor advised that an oral surgeon should be consulted, but no one followed up. Please let me know your opinion. I know that debridement is necessary, but I am concerned that the ENT alone is not the proper doctor to call regarding the type of debridement. He advised today that an oral surgeon was unnecessary while speaking to my sister.

Thank you.

Hi doctor,

Thank you for your answer.

The following is a report (attachment removed for patient identity protection) from the infection control doctor, who advised that a CT scan showed a destructive lesion in her left mandible with drainage. Blood culture with coagulase-negative staphylococci, which is a contaminant. The infection control doctor possibly orders a culture advising that Actinomyces cannot be ruled out. The results are pending. Surgery to place a drain in the infected site was done. The swelling in her jaw and neck area has decreased tremendously. Antibiotics have been started, but the doctor insists on doing a mandibulectomy without reconstruction. I am still determining the current antibiotic therapy effectiveness. He seems to be in a rush. I do not know if he has ever performed this type of surgery. The information on health grades and his practice website does not indicate he is a dentist or oral surgeon. There is no indication he has any training in those disciplines. I will upload the infection control doctor's report and send it to you. He already knows how much of the mandible needs to be removed. The ENT advised that he was sending a sample off to be tested. However, he advised it did not visually appear to be cancer. I do not know because he has not mentioned the results. He insisted that a mandibulectomy was necessary, the night he placed the drain into the jaw. Unfortunately, this appears to be the only option.

Thank you.

Hi doctor,

Thank you for your answer.

I have included several reports from the infection control doctor, the ENT, the physician, and other individuals and doctors who are providing care.

Thank you.

Hi doctor,

I have attached the file.

Thank you.

Hi doctor,

Thank you for your answer.

Some more files are attached.

Thank you.

Hi doctor,

Thank you for your answer.

The ENT has already placed a drain into the infected area. She is currently intubated to keep her airway open due to throat swelling. ENT wants to place a trachea and do surgery. He makes it sound as if we have no opinion. He advised he would do a segmental or total removal of the mandible. I am terrified, and my mom is nervous. He wants to do surgery today. She was referred to an oral surgeon, but she went to the hospital when her face swelled up with pus. Do you think the antibiotic protocol is sufficient until oral surgery is called in? Also, the oral surgeon with whom she has an appointment seems to be a staff or board member in this hospital. Should I be asked that he be called in? The ENT plans to do reconstruction. I will forward the culture reports once received.

Thank you.