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Extensive Skull Base Osteomyelitis Secondary to Malignant Otitis Externa

Luca Bruschini1, Stefano Berrettini1, Cambi Christina1

  • 1ENT Audiology and Phoniatric Unit, University Hospital of Pisa, Pisa, Italy.

The Journal of International Advanced Otology
|March 30, 2019
PubMed

Insights

Skull base osteomyelitis, a complication of malignant otitis externa, can spread extensively. This case shows severe skull base and cervical spine involvement, even contralaterally, over three years.

Area of Science:

  • Radiology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Skull base osteomyelitis is a severe complication of malignant otitis externa.
  • Diagnosis typically relies on clinical, microbiological, and radiological assessments.

Observation:

  • A 76-year-old man presented with right-sided malignant otitis externa involving otomastoid structures and the temporal bone.
  • Over three years, skull base osteomyelitis progressed despite antibiotic therapy.

Findings:

  • The infection spread to involve the entire skull base, including the contralateral petrous temporal bone.
  • Cervical vertebral processes were also affected, demonstrating an exceptional extent of disease.

Implications:

  • This case highlights the potential for aggressive progression of malignant otitis externa and skull base osteomyelitis.
  • It underscores the importance of comprehensive imaging and long-term monitoring for extensive infections.

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