Tinnitus Associated with Mild Osteomyelitis of the Temporal Bone Reversed after Conservative Antibiotic Treatment: A Case Series

Abstract

The symptomatology and diagnostic tools for osteomyelitis of the temporal bone have not been well documented. Diagnosis of early stage (i.e., mild form) osteomyelitis of the temporal bone may be delayed due to the limitations of traditional computed tomography’s (CT) imaging resolution. With the advancement of high-resolution CT (HRCT) images, clinicians can now observe images that could not be observed with traditional CT imaging. In this neuro-image report, we present three patients with refractory/untreatable tinnitus. In their HRCT images, mild osteomyelitis of the temporal bone was revealed by mucosa thickening with bony sequestration of air cells, mild opacification of the air cells, and soft tissue density in the middle ear cavity, mild opacification, and bony sequestration attributed to mucosa thickening of the mastoid air cells (along with the cortical bone). All of the clinical presentations and findings in the pure tone audiometry of the reported patients improved after adequate antibiotic treatment. The current report highlights the potential benefit of HRCT to diagnose this in such patients. In addition, immediate and conservative antibiotic treatment is recommended for managing these patients shortly after the detection of mild osteomyelitis of the temporal bone. This treatment could reduce the risk of progression to the severe form.

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

“…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.…”

“…One of the surprising results of the current study was a statistically significant association between tinnitus and evidence of SBO on imaging (specificity: 96.7%). 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 .…”

Pfizer–BioNTech COVID-19 vaccine-associated tinnitus and treatment with transcranial magnetic stimulation

“…The high-resolution computed tomography on 26 February 2021 showed mild temporal bone inflammatory change, which was similar with our previous case report. 3 The baseline pure tone audiometry (PTA) on 22 March 2021 showed right extreme high tone mild sensorineural hearing loss and left extreme high tone mild-to-moderate sensorineural hearing loss ( Figure 1A ). She started to receive low-dosage ceftriaxone 1 gm every week since mid-May 2021.…”