AU  - Steinhart H
AU  - Schulz S
AU  - Mutters R
TI  - Evaluation of ozonated oxygen in an experimental animal 
      model of osteomyelitis as a further treatment option for 
      skull-base osteomyelitis.
AB  - The standard treatment of chromic skull-base osteomyelitis 
      is antibiotics and surgical removal of sequestrums. Hyperbaric 
      oxygen therapy has been found to be a useful method for 
      managing refractory cases of chronic osteomyelitis. Since 
      a minimal blood supply is needed for hyperbaric oxygen 
      therapy, chronic osteomyelitis can produce necrotic infected 
      areas that are not nutrified and therefore not assessable 
      for hyperbaric oxygen therapy. Ozone is known to be an 
      oxidizing medium with a strong bactericidal effect. We 
      investigated the influence of locally applied ozonated 
      oxygen on the development of chronic osteomyelitis in an 
      experimental animal model using the femur of the rabbit.
      The proximal sides of the femurs of 40 rabbits were prepared 
      and a needle inserted into the intramedullary cavity. Osteomyelitis 
      was induced with an infusion of Staphylococcus aureus and 
      sodium morrhuate into the bone. The needle was left in 
      a intramedular location. After a 4-week delay animals were 
      randomly separated into treatment and control groups. The 
      infected femur of treated animals was flushed three times 
      a day with 20 ml of ozonated oxygen at an ozone concentration 
      of 107 micrograms/ml O2 over periods of 2 or 4 weeks. Clinical,
      radiographic and microbiological findings were documented.
      Chronic osteomyelitis occurred in all animals. Ten rabbits 
      were excluded from further study during the investigation 
      because of excessive weight loss (> 15% of the original 
      weight). Bacterial cultures showed no significant reduction 
      of S. aureus concentrations in the ozone-treated group,
      although comparison of radiographic results revealed less 
      serious osteomyelitis-related bone damage in these animals 
      (P < 0.01). These findings indicate that refractory osteomyelitis 
      in the head and neck may benefit from locally applied "
      flush" therapy with ozonated oxygen in addition to treatment 
      with antibiotics, surgery and hyperbaric oxygen.

SO  - Eur Arch Otorhinolaryngol 1999; 256(3):153-7
DP  - 1999
TA  - Eur Arch Otorhinolaryngol
PG  - 153-7
VI  - 256
UI  - 99250745