Abstract
PURPOSE: This study presents a rare case of primary tubercular osteomyelitis of the zygoma, and addresses how combined surgical and medical treatments are effective managing rare presentations of tubercular osteomyelitis in facial bones. METHODS: A 57-year-old man presented with pain and purulent discharge from the right malar region following trauma. Initial treatments with empirical antibiotics had poor response, hence further investigations were done. Comprehensive diagnostic workup included lab tests, Computed tomography with contrast, and histopathological examination. The patient underwent surgical debridement of the zygomatic bone through an intraoral approach, and debrided tissue was sent for microbiological and histopathological examination, which confirmed tubercular osteomyelitis. Post-surgery, the patient was treated with a four-drug anti-tubercular regimen. RESULTS: Following anti-tubercular therapy, the patient showed significant improvement, with no signs of disease recurrence after a year of follow-up. CONCLUSION: Primary tubercular osteomyelitis of the zygoma is extremely rare but should be considered in differential diagnoses of facial swellings and discharging sinuses. This case underscores the importance of a multidisciplinary approach in treating rare presentations of tubercular osteomyelitis.