Comparative study of reliability of inflammatory markers over 18-FDG−PET CT scan in monitoring skull base osteomyelitis

Faizal, Bini; Surendran, Bhavya; Kumar, Madhumita

doi:10.1016/j.bjorl.2020.09.012

Cited by 10 publications

(16 citation statements)

References 22 publications

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“…13 Patients generally became asymptomatic after a few weeks of antibiotic therapy, but it might be ideal to continue medications till inflammatory markers and or PET CT became normal. 7,8 We observed a sequence, of symptom resolution followed by stabilization of inflammatory markers and later radiological stability. After the initial diagnosis, we did not repeat imaging unless there were new symptoms.…”

Section: Discussionmentioning

confidence: 85%

“…We used absent activity in PET scans as an indicator of cure in our patients. 7 The rapidity of relief from pain, ear discharge, edema of the ear canal, granulations, and duration of treatment in both groups were evaluated. For the medical group, the entire duration of antimicrobial treatment was taken.…”

Section: Inclusion Criteriamentioning

confidence: 99%

“…PET CT and PET MRI having a superior spatial resolution, less radioactivity, and higher sensitivity and specificity, have been preferred lately over other nuclear scans to diagnose and determine the resolution of SBO. [5][6][7][8] When initially described by Chandler, the treatment was mainly surgical, along with antibiotics like Colistin or Polymixin, with a mortality of 46%. 1 With broad-spectrum antibiotics, surgical interventions have become a rarity, and mortality has reduced to 10%.…”

Section: Introductionmentioning

confidence: 99%

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Role of surgery and antimicrobials in refractory skull base osteomyelitis- a prospective study.

Faizal

Nair

Pavithran

et al. 2022

Preprint

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Objective: To analyse the role of surgery along with antimicrobials to improve clinical outcomes in treating refractory cases of skull base osteomyelitis (SBO). Study design and setting: A prospective comparative study in a tertiary care centre with 70 SBO patients meeting eligibility criteria. Participants: The study population comprised 35 patients refractory to systemic antimicrobials of at least four weeks duration who later underwent surgery in addition to medication (surgical group). They were compared with a medical group that responded to medications alone. Main outcome measures: The outcome variables studied were the resolution of clinical features (pain, discharge, radiology, and inflammatory markers), culture yield, and total duration of treatment. Results: According to our study, relief of pain was faster in the surgical group(1.66 against 4.57 months) with statistical significance (p< 0. 001). Relief of symptoms (p< 0.001), radiological improvement (p= 0.001), and normalizing of inflammatory markers (p<0.001) were better in the surgical group than in the medical group. The duration of treatment was an average of 9. 2 months in the surgical group compared to 11.3 months in the medical group (p= 0.019). Microbial culture from deep tissue sampling was positive in 24 surgical patients (68.57%). Conclusion: The treatment response to surgery and antimicrobials in treating refractory cases of SBO was better than the group who responded to antimicrobials alone. Surgery provided higher microbial yield resulting in culture-specific antimicrobials. The surgical group observed faster relief of symptoms, reduced hospital stay, and total treatment duration.

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Section: Discussionmentioning

confidence: 85%

Section: Inclusion Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Role of surgery and antimicrobials in refractory skull base osteomyelitis- a prospective study.

Faizal

Nair

Pavithran

et al. 2022

Preprint

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“…Furthermore, the ability of [ 18 F]FDG PET/CT to allow the discontinuation of therapy in SBO has also emerged [ 20 ]. It has been reported that patients that did not demonstrate any increased metabolic activity at the time of [ 18 F]FDG PET/CT evaluation remained free of symptoms; conversely, it was suggested to continue the treatment of SBO until the normalization of [ 18 F]FDG uptake, also in asymptomatic patients [ 27 ]. Interestingly, if performed in early stages of SBO, [ 18 F]FDG PET/CT may also allow the early identification of the most suitable site to perform biopsy, in order to establish a clear microbiological diagnosis and therefore start a specific therapy [ 20 ].…”

mentioning

confidence: 99%

“…Interestingly, if performed in early stages of SBO, [ 18 F]FDG PET/CT may also allow the early identification of the most suitable site to perform biopsy, in order to establish a clear microbiological diagnosis and therefore start a specific therapy [ 20 ]. An excellent correlation between inflammatory markers and [ 18 F]FDG PET/CT was also reported and concordance of C-reactive protein (CRP) levels with PET/CT results and their ability to guide the follow-up of patients were underlined in some cases [ 21 , 27 ].…”

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confidence: 99%