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Acute mastoiditis and osteomyelitis of the temporal bone
Mickey Dudkiewicz1, Gilat Livni, Liora Kornreich
1Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Petah Tiqwa, Israel.
Summary
This study highlights osteomyelitis of the temporal bone as an unusual complication of acute mastoiditis. Early detection and treatment, including antibiotics and surgery, lead to a good prognosis for this rare condition.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Head and Neck Surgery
Background:
- Acute mastoiditis can involve periosteitis when infection spreads through the periosteum.
- Osteomyelitis of the temporal bone is an atypical, but significant, complication of acute mastoiditis.
Purpose of the Study:
- To describe the clinical presentation, diagnosis, and management of osteomyelitis of the temporal bone secondary to acute mastoiditis.
- To identify characteristics of this unusual complication and its treatment outcomes.
Main Methods:
- Retrospective review of patients admitted for acute mastoiditis between September 2001 and December 2003.
- Inclusion criteria: symptoms, signs, and imaging findings of osteomyelitis extending beyond the mastoid area.
- Analysis of diagnostic work-up, radiographic findings, and treatment strategies.
Main Results:
- Six patients (5% of 120) were identified with temporal bone osteomyelitis.
- Common pathogens included Staphylococcus, Bacteroides, and Streptococcus pneumoniae.
- Computerized tomography revealed temporal bone destruction in all cases; other complications included sinus vein thrombosis and epidural abscess.
Conclusions:
- Osteomyelitis of the temporal bone is an unusual complication of acute mastoiditis, characterized by treatment resistance and specific CT findings.
- Management involves broad-spectrum antibiotics and surgical intervention, such as cortical mastoidectomy.
- Prompt diagnosis and treatment result in a favorable prognosis.