Central Skull Base Osteomyelitis


Authors: A. Mifková 1;  V. Živicová 1;  M. Chovanec 2;  J. Kluh 1;  J. Lisý 3;  J. Plzák 1;  Z. Fík 1;  J. Bouček 1
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku, 1. lékařská fakulta, Univerzita Karlova, Fakultní nemocnice v Motole, Praha 1;  Otorinolaryngologická klinika, 3. lékařská fakulta, Univerzita Karlova, Fakultní nemocnice Královské Vinohrady, Praha 2;  Klinika zobrazovacích metod, 2. lékařská fakulta, Univerzita Karlova, Fakultní nemocnice v Motole, Praha 3
Published in: Otorinolaryng. a Foniat. /Prague/, 67, 2018, No. 1, pp. 32-35.
Category: Case Reports

Overview

Central skull base osteomyelitis is a very rare, life threatening disease. There are only few reported cases in the literature. The disease is generally associated with infections of the petrous bone, less often with sinonasal inflammation. It presents a diagnostic and therapeutic challenge with varied symptomatology and differential diagnosis. There was one patient treated for the proven central skull base osteomyelitis during the year 2015 at the Department of Otorhinolaryngology and Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol. The inflammatory process followed chronic mesotitis with mastoiditis which required surgical intervention. Clinically the disease presented with bilateral hypoglossal palsy and single-sided vagal palsy. Diagnosis has been confirmed by MRI and scintigraphy with labeled leukocytes. Complete remission with the restoration of the cranial nerves function has been achieved due to the long-term antimicrobial therapy (10 weeks) against cultivated Pseudomonas aeruginosa. Despite our success in the treatment, central skull base osteomyelitis is a serious disease with significant mortality even if treated properly.

Keywords:
skull base osteomyelitis, otitis media, cranial nerve palsy, scintigraphy, Pseudomonas aeruginosa


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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