Clinical characteristics and complications of skull base osteomyelitis: A 12-year study in a teaching hospital in South India

被引:19
作者
Das, Sohini [1 ]
Iyadurai, Ramya [1 ]
Gunasekaran, Karthik [1 ]
Karuppusamy, Reka [2 ]
Mathew, Zacharia [1 ]
Rajadurai, Ebenezer [1 ]
John, Ajoy O. [1 ]
Mani, Sunithi [3 ]
George, Tina [1 ]
机构
[1] Christian Med Coll & Hosp, Dept Med, Vellore, Tamil Nadu, India
[2] Christian Med Coll & Hosp, Dept Biostat, Vellore, Tamil Nadu, India
[3] Christian Med Coll & Hosp, Dept Radiodiag, Vellore, Tamil Nadu, India
关键词
Non-otogenic skull base osteomyelitis; otogenic skull base osteomyelitis; skull base osteomyelitis;
D O I
10.4103/jfmpc.jfmpc_62_19
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Context: Skull base osteomyelitis (SBO) is an uncommon disease with substantial morbidity and mortality. Aims: The aim of this study is to characterize clinical features, outcomes, and complications of SBO. We also looked at differences in clinical profile in otogenic and non-otogenic SBO. Materials and Methods: This is a single-center retrospective observational study. Patients aged more than 15 years of age with clinical and radiological diagnosis of SBO admitted in general medicine department in a teaching hospital in South India from March 2006 to February 2018 were recruited. Results: A total of 41 patients with SBO were identified and included. Mean age was 56.9 +/- 10.7 years. In all, 90% of patients (37/41) had diabetes mellitus and 29% (12/41) had recent head/neck surgery. Only 19% (8/41) needed ICU care, and mortality was 21% (9/41). Most common symptom was headache seen in 73% (30/41) of patients. Majority, 61% (25/41), had otogenic infections. Otogenic infections were associated with longer duration of diabetes mellitus (mean = 11.5 vs. 5 years, P = 0.01), higher creatinine levels (mean = 1.66 vs. 0.9 mg/dL, P = 0.014, odds ratio [OR] = 3.8), and higher incidence of cranial nerve palsy (92% vs. 56%; OR = 8.9) compared to non-otogenic SBO. Cranial nerve palsy (78%), meningitis (63%), and cerebral venous thrombosis (43%) were frequent complications of SBO in this study. The causative organisms for SBO in our cohort was bacterial in 60% (15/25) and fungal in 40% (10/25) of the patients. Surgical debridement for source control was done in 54% of patients (22/41) and was associated with survival at discharge (P = 0.001). Conclusions: Bacterial infections are the most common cause of SBO. Otogenic SBO is associated with longer duration of diabetes mellitus and higher incidence of cranial nerve palsy. Therapeutic surgical debridement plays an important role in treatment of SBO and is associated with improved survival.
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页码:834 / 839
页数:6
相关论文
共 30 条
[1]   Temporal bone osteomyelitis and temporoparietal abscess secondary to malignant otitis externa [J].
Alva, B. ;
Prasad, K. Chandra ;
Prasad, S. Chandra ;
Pallavi, S. .
JOURNAL OF LARYNGOLOGY AND OTOLOGY, 2009, 123 (11) :1288-1291
[2]   Skull-base osteomyelitis: fungal vs. bacterial infection [J].
Blyth, C. C. ;
Gomes, L. ;
Sorrell, T. C. ;
da Cruz, M. ;
Sud, A. ;
Chen, S. C. -A. .
CLINICAL MICROBIOLOGY AND INFECTION, 2011, 17 (02) :306-311
[3]   Otogenic sigmoid sinus thrombosis: What is the role of anticoagulation? [J].
Bradley, DT ;
Hashisaki, GT ;
Mason, JC .
LARYNGOSCOPE, 2002, 112 (10) :1726-1729
[4]   Malignant external otitis: The shifting treatment paradigm [J].
Carlton, Daniel A. ;
Perez, Enrique E. ;
Smouha, Eric E. .
AMERICAN JOURNAL OF OTOLARYNGOLOGY, 2018, 39 (01) :41-45
[5]   Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy [J].
Chakraborty, Dhritiman ;
Bhattacharya, Anish ;
Gupta, Ashok Kumar ;
Panda, Naresh Kumar ;
Das, Ashim ;
Mittal, Bhagwant Rai .
INDIAN JOURNAL OF NUCLEAR MEDICINE, 2013, 28 (02) :65-69
[6]   MALIGNANT EXTERNAL OTITIS [J].
CHANDLER, JR .
LARYNGOSCOPE, 1968, 78 (08) :1257-&
[7]   Neonatal Infected Subgaleal Hematoma: An Unusual Complication of Early-onset E. coli Sepsis [J].
Chang, Hung-Yang ;
Cheng, Kun-Shan ;
Liu, Yu-Peng ;
Hung, Hsiao-Fang ;
Fu, Hua-Wen .
PEDIATRICS AND NEONATOLOGY, 2015, 56 (02) :126-128
[8]  
Chang PC, 2003, AM J NEURORADIOL, V24, P1310
[9]   Central Skull Base Osteomyelitis Presenting Only With a Severe Headache [J].
Choi, Pahn K. ;
Chung, Ji Y. ;
Kang, Hyun G. .
HEADACHE, 2018, 58 (08) :1236-1237
[10]   Central or Atypical Skull Base Osteomyelitis: Diagnosis and Treatment [J].
Clark, Matthew P. A. ;
Pretorius, Pieter M. ;
Byren, Ivor ;
Milford, Chris A. .
SKULL BASE-AN INTERDISCIPLINARY APPROACH, 2009, 19 (04) :247-254