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Review
. 2022 Jul;80(7):1254-1259.
doi: 10.1016/j.joms.2022.04.015. Epub 2022 May 6.

COVID-Associated Avascular Necrosis of the Maxilla-A Rare, New Side Effect of COVID-19

Victoria A Mañón  1 , Steven Balandran  2 , Simon Young  3 , Mark Wong  4 , James C Melville  5
Affiliations
Review

COVID-Associated Avascular Necrosis of the Maxilla-A Rare, New Side Effect of COVID-19

Victoria A Mañón et al. J Oral Maxillofac Surg. 2022 Jul.

Abstract

Purpose: The purpose of this article is to present an interesting, rare case of a patient who experienced avascular necrosis of the maxilla associated with COVID-19 infection.

Methods and results: Our team retrospectively evaluated this patient's chart after completion of surgical management. The patient is a 72-year-old male who presented to the University of Texas Health Science Center at Houston for surgical management of his infarcted maxilla, which developed as a sequela of infection with COVID-19. A literature review was completed using PubMed. Twenty-five articles are reviewed and discussed.

Conclusions: Infection with COVID-19 confers a hypercoagulable state in patients, leading to various complications in the head and neck region. In our case report, we present a patient who developed avascular necrosis of the maxilla secondary to infection with COVID-19. Thromboembolic prophylaxis is imperative in COVID-19 patients due to the high rate of potential systemic complications.

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Figures

Figure 1
Figure 1
Clinical photo from the patient's initial presentation to the UTHSC-H OMFS clinic. There is necrotic, exposed bone on the labio-buccal surfaces of the left and right maxillary quadrants with suppuration. UTHSC-H OMFS, University of Texas Health Science Center at Houston Oral and Maxillofacial Surgery.
Figure 2
Figure 2
A, Axial view. There are osteolytic changes seen on the hard palate, superior alveolar ridge, and left maxilla. B, Axial view. There are osteolytic changes seen on the left maxilla, zygoma, and left ethmoid air cells. C, Coronal view. There are osteolytic changes seen on the hard palate, superior alveolar ridge, left maxilla, zygoma, zygomatic arch, and left ethmoid air cells. D, Sagittal view. There are osteolytic changes seen on the hard palate, superior alveolar ridge, left maxilla, and left ethmoid air cells.
Figure 3
Figure 3
Neck CTA demonstrating occlusion of a branch of the left maxillary artery. Abbreviation: CTA, computed tomography angiography.
Figure 4
Figure 4
A, Surgical debridement of the right and left maxillary necrotic bone. B, Necrotic bone debrided from the right and left maxilla.
Figure 5
Figure 5
Primary closure of the maxilla after debridement.
See this image and copyright information in PMC

References

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