Skull base osteomyelitis: Comprehensive analysis and a new clinicoradiological classification system

Area of Science:

• Infectious Diseases
• Neurosurgery
• Radiology

Background:

• Skull base osteomyelitis (SBO) is a rare but severe infection with high morbidity and mortality.
• Diabetic and immunocompromised individuals are particularly susceptible to SBO.
• Effective management requires accurate assessment and prognostication.

Purpose of the Study:

• To analyze treatment outcomes for SBO patients at a single institution.
• To develop and validate a novel integrated clinicoradiological classification system for SBO.

Main Methods:

• Retrospective review of 32 SBO patients treated between 2006 and 2017.
• Development of an MRI-based anatomical involvement scoring system.
• Integration of the scoring system with cranial nerve dysfunction to form a clinical grading system (CGS).

Main Results:

• Diabetes (78.1%) and cranial nerve dysfunction (63%) were common in SBO patients.
• Higher clinical grade (CG) correlated with decreased regression rates and increased hospitalization duration.
• The proposed CG system showed significant correlation with overall survival (P=0.017).

Conclusions:

• SBO remains a challenging condition with substantial mortality.
• The new clinicoradiological classification system can assist clinicians in stratifying SBO patients.
• This system aids in estimating patient prognosis based on integrated clinical and radiological data.