Temporal Bone Osteomyelitis: The Relationship with Malignant Otitis Externa, the Diagnostic Dilemma, and Changing Trends

Chen, Jia-Cheng; Yeh, Ching-Fa; Shiao, An‐Suey; Tu, Tzong-Yang

doi:10.1155/2014/591714

Cited by 26 publications

(21 citation statements)

References 19 publications

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“…SBO commonly occurs as a complication of MOE and chronic mastoid infections or secondary to sphenoidal sinusitis. [ 29 30 31 ] MOE primarily affects the temporal bone and is the most frequent cause of SBO. [ 31 ] A large study at the University of California Irvine from 1990 to 2000 reported a male-to-female ratio of 1:1 in 820 patients with SBO.…”

Section: Discussionmentioning

confidence: 99%

“…[ 29 30 31 ] MOE primarily affects the temporal bone and is the most frequent cause of SBO. [ 31 ] A large study at the University of California Irvine from 1990 to 2000 reported a male-to-female ratio of 1:1 in 820 patients with SBO. [ 32 ] The researchers reported the overall incidence of SBO as 69.3% in whites, 13.2% in Native Americans, 6.5% in African Americans, and 2.9% in Asians.…”

Section: Discussionmentioning

confidence: 99%

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A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Khan¹,

Quadri²,

et al. 2018

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Skull base osteomyelitis (SBO) is a complex and fatal clinical entity that is often misdiagnosed for malignancy. SBO is commonly a direct complication of otogenic, sinogenic, odontogenic, and rhinogenic infections and can present as central, atypical, or pediatric clival SBO. This review describes the clinical profile, investigational approach, and management techniques for these variants. A comprehensive literature review was performed in PubMed, MEDLINE, Research Gate, EMBASE, Wiley Online Library, and various Neurosurgical and Neurology journals with the keywords including: SBO, central or atypical SBO, fungal osteomyelitis, malignant otitis externa, temporal bone osteomyelitis, and clival osteomyelitis. Each manuscript's reference list was reviewed for potentially relevant articles. The search yielded a total of 153 articles. It was found that with early and aggressive culture guided long-term intravenous broad-spectrum antibiotic therapy decreases post-infection complications. In cases of widespread soft tissue involvement, an early aggressive surgical removal of infectious sequestra with preferentially Hyperbaric Oxygen (HBO) therapy is associated with better prognosis of disease, less neurologic sequelae and mortality rate. Complete resolution of the SBO cases may take several months. Since early treatment can improve mortality rates, it is paramount that the reporting radiologists and treating clinicians are aware of the cardinal diagnostic signs to improve clinical outcomes of the disease. It will decrease delayed diagnosis and under treatment of the condition. However, due to rarity of the condition, complete prognostic factors have not fully been analyzed and discussed in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Khan¹,

Quadri²,

et al. 2018

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“…The skull base inflammations described in the literature most often affect diabetic or immunodeficient patients [2, 17–19]. Diabetics are more prone to skull base osteomyelitis [3, 8–10, 17, 19, 20].…”

Section: Discussionmentioning

confidence: 99%

Skull base osteomyelitis: factors implicating clinical outcome

et al. 2019

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Skull base osteomyelitis is a serious disease with a high risk of complications including neuroinfection. Typically, the inflammation of the skull base results from infection from neighboring tissues. In case of malignant otitis externa, inflammation disseminates from the external auditory canal. In this study, we present our experience with seven patients diagnosed with skull base osteomyelitis that began with otitis externa and have been treated in our department for the last 10 years. Department Patient Database was searched for the diagnosis skull base osteomyelitis. The search covered the last 10 years. The search revealed seven patients who met the above-described criteria. Medical records of those patients were carefully analyzed including age, gender, symptoms and signs, diagnostics details, treatment, performed procedures, number of hospitalization days, comorbid diseases, and complications including any cranial nerve palsy. Detailed analysis of medical records of patients included in this study showed that skull base osteomyelitis presents a challenge for diagnosis and treatment. Treatment strategy requires prolonged aggressive intravenous antibiotic therapy, and in some cases combined with surgical intervention. Cranial nerve paresis indicates progression of the disease and is associated with longer hospital stay. Similar relationship is observed in patients with skull base osteomyelitis that required surgery. Diabetes in patient’s medical history may complicate the healing process. Diabetes, neural involvement, and surgery may overlap each other resulting in longer hospital stay. Cranial nerve paresis may not resolve completely and some neural deficits become persistent.

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“…At the first examination, ESR levels were found to be increased by 50%-80% and CRP levels by 66.7%-78.6% in our study. As a result, ESR and CRP may be useful laboratory markers for the screening of MOE (20).…”

Section: Discussionmentioning

confidence: 99%