Prediction of skull base osteomyelitis in necrotising otitis externa with diffusion-weighted imaging

Razek, Abdel; Mahmoud, Walaa

doi:10.1017/s0022215120001073

Cited by 7 publications

(5 citation statements)

References 46 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, diffusion-weighted MRI can aid in interpreting findings during follow-up [16]. Whereas conventional MRI often demonstrates persistent abnormal signals, different apparent diffusion coefficients in diffusion-weighted MRI seem to sufficiently distinguish between MOE with and without skull base involvement [31 ▪▪ ]. Additionally, the modality does not require administration of contrast agent, does not expose radiation, and is easily available.…”

Section: Imagingmentioning

confidence: 99%

Current management of skull base osteomyelitis

Auinger¹,

Arnoldner²

2021

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

View full text Add to dashboard Cite

Purpose of review Skull base osteomyelitis (SBO) is a life-threatening condition. Due to an aging and increasingly multimorbid population, clinicians are more often challenged with this disease. Yet, there is no consensus on the optimal diagnostic and follow-up management. This review should aid clinicians in decision-making for their patients. Recent findings Treatment-resistant otalgia or headache is suspicious of SBO. Pseudomonas aeruginosa remains the most common pathogen but clinicians are challenged with increasing rates of sterile or fungal cultures due to previously applied antibiotics/steroids. No single imaging modality is able to detect the full extent of the disease. Whereas functional nuclear imaging with gallium-67 or methylene diphosphonate-technetium-99m was once advocated, its actual benefit is questionable. Newer modalities such as fluoro-D-glucose-positron emission tomography (PET)/computed tomography, PET/magnetic resonance imaging (MRI), or diffusion-weighted MRI seem to be promising in diagnosis and follow-up. Finding the causative pathogen is of utmost importance followed by long-term intravenous antibiotics until the disease has completely resolved. Surgery plays a minor role in treatment but can be helpful in selected cases. Summary The numerous challenges in SBO render management difficult, but with a clear work-up including regular clinical, laboratory and imaging examinations, outcome can be improved.

show abstract

Section: Imagingmentioning

confidence: 99%

Current management of skull base osteomyelitis

Auinger¹,

Arnoldner²

2021

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

View full text Add to dashboard Cite

show abstract

“… 35 While several strategies have been proposed to assess the risk of incidence and severity of SBO, identifying a simple clinical feature for this purpose can be promising. 36 Since firm conclusions cannot be drawn from this finding, an investigation of this association is warranted in future studies. Also, tinnitus was related to hearing loss in our study ( p ≤ 0.05); even though the hearing loss was conductive type in all patients suffering from it.…”

Section: Discussionmentioning

confidence: 90%

“…Even though the tinnitus mechanism is not entirely understood, it might improve by treatment of the underlying SBO 35 . While several strategies have been proposed to assess the risk of incidence and severity of SBO, identifying a simple clinical feature for this purpose can be promising 36 . Since firm conclusions cannot be drawn from this finding, an investigation of this association is warranted in future studies.…”

Section: Discussionmentioning

confidence: 99%

Cranial nerve palsy prevalence and associated factors in patients with malignant otitis externa

Zonnour

Shahnazar

Jamshidi

et al. 2023

Laryngoscope Investig Oto

View full text Add to dashboard Cite

Objective To identify the prevalence of cranial nerve (CN) palsy and its associated factors in malignant otitis externa (MOE). Methods In a retrospective study, records of MOE patients from 2011 to 2014 were reviewed. MOE and CN involvement were evaluated based on patient demographics, clinical, and paraclinical data. Results Overall, 119 MOE patients with a mean age of 65.9 ± 11.3 were included. 69.7% were male, and 63.0% had a history of diabetes. The most common symptoms and signs were otalgia (97.5%), otorrhea (44.5%), and ear canal erythema/edema (24.4%). Thirty‐three patients (27.7%) had CN involvement. The facial nerve was mostly involved (26.1%). Skull base osteomyelitis (SBO) was present in 59 patients. When excluding patients younger than 30 and older than 80, age decade was correlated with CN palsy. 66.9% of patients with CN palsy and 65.6% without CN palsy were male, which was significantly different. The following factors were not significantly different between patients with and without CN palsy: Comorbidities, signs and symptoms, diagnostic delay, erythrocyte sedimentation rate level, fasting blood sugar, hemoglobin A1c level, antifungal therapy, hospitalization duration, and SBO on imaging. Tinnitus was correlated with SBO evidence on imaging (specificity: 96.7%). Conclusion CN involvement occurs in about three out of 10 MOE patients. Male gender and advanced age may be related to a higher incidence rate of CN palsy. Tinnitus can be a specific indicator of SBO. These findings could help in better decision‐making for early interventions. Level of Evidence 4.

show abstract

“…Abdel Razek et al examined the role of diffusion weighted imaging (DWI) in predicting SBO in 25 NEO patients [25 ▪ ]. A statistically significant difference was found in skull base apparent diffusion coefficient (ADC) values with or without SBO.…”

Section: Imaging Findings and Role Of Different Modalitiesmentioning

confidence: 99%

Skull base osteomyelitis imaging

Singhal

Sotoudeh

Chapman

2021

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

View full text Add to dashboard Cite

Purpose of review Skull base osteomyelitis (SBO) is a challenging entity to diagnose and treat. The goal of this review is to summarize the imaging findings of SBO and present these in the context of recent studies on imaging of SBO. Recent findings This review discusses the clinical presentation, pathophysiology and imaging appearances of SBO. The review further emphasizes the results of latest studies on imaging of SBO, and the role of different modalities in diagnosis and evaluation of disease course and treatment response. Brief discussion on differential diagnoses from an imaging standpoint is also included. Summary Various imaging modalities play different and complimentary roles in diagnosis and management of SBO, which are discussed in this review.

show abstract

Prediction of skull base osteomyelitis in necrotising otitis externa with diffusion-weighted imaging

Cited by 7 publications

References 46 publications

Current management of skull base osteomyelitis

Current management of skull base osteomyelitis

Cranial nerve palsy prevalence and associated factors in patients with malignant otitis externa

Skull base osteomyelitis imaging

Contact Info

Product

Resources

About