Current management of skull base osteomyelitis

Area of Science:

• Infectious Diseases
• Neurology
• Otolaryngology
• Radiology

Background:

• Skull base osteomyelitis (SBO) is a severe infection posing increasing challenges due to patient demographics.
• Optimal diagnostic and follow-up strategies for SBO are not yet standardized.
• This review aims to guide clinicians in managing SBO.

Purpose of the Study:

• To provide a comprehensive overview of current diagnostic and management approaches for SBO.
• To highlight challenges and recent advancements in SBO care.
• To assist clinicians in making informed decisions for SBO patients.

Main Methods:

• Literature review of diagnostic modalities and treatment strategies for SBO.
• Analysis of imaging techniques, including conventional and advanced methods.
• Evaluation of antimicrobial and surgical treatment protocols.

Main Results:

• Persistent otalgia or headache may indicate SBO.
• Pseudomonas aeruginosa is a common pathogen, but sterile/fungal cultures are increasing.
• Advanced imaging like PET/CT, PET/MRI, and diffusion-weighted MRI show promise for diagnosis and follow-up.
• Long-term intravenous antibiotics are essential, with surgery reserved for select cases.

Conclusions:

• Effective management of SBO requires a clear, systematic work-up.
• Regular clinical, laboratory, and imaging assessments are vital.
• Improved outcomes are achievable with a structured approach to SBO management.