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Skull Base Osteomyelitis- Microbiological Profile and Management Implications.

Katti Blessi Sara1, Zachariah Thomas1, P Lokesh Kumar2

  • 1Department of Otorhinolaryngology, Christian Medical College, Vellore, Tamilnadu 632004 India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|May 27, 2025
PubMed
Summary
This summary is machine-generated.

Skull base osteomyelitis (SBO) is a severe infection. Early diagnosis via targeted biopsy and culture-specific antibiotics significantly improve outcomes for patients with this dangerous condition.

Keywords:
Atypical osteomyelitisMalignant otitis externaSkull base osteomyelitisTargeted biopsy

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Neurosurgery

Background:

  • Skull base osteomyelitis (SBO) is a life-threatening infection with high morbidity and mortality.
  • Common origins include otogenic, rhinogenic, and odontogenic sources.
  • Key symptoms include severe nocturnal pain and cranial nerve palsies.

Purpose of the Study:

  • To retrospectively analyze demographic, clinical, surgical, and microbiological data of 134 patients with SBO.
  • To evaluate the effectiveness of targeted biopsy, debridement, and culture-specific antibiotic treatment.

Main Methods:

  • Retrospective review of clinical data from 134 SBO patients.
  • Analysis of demographic details, clinical features, surgical procedures, and microbiological profiles.
  • 123 patients underwent targeted biopsy and debridement.

Main Results:

  • The cohort had a male preponderance, mean age of 60, and mean HbA1C of 8.4 (uncontrolled diabetes).
  • Severe otalgia and facial nerve palsy were the most common symptoms.
  • Culture-positive rate was 85.4%, with Pseudomonas, Aspergillus, and Staphylococcus spp. as common pathogens.
  • 85% clinical improvement was observed with targeted biopsy, debridement, and culture-specific antibiotics.

Conclusions:

  • SBO is a serious bacterial or fungal infection requiring early diagnosis.
  • Targeted biopsy can achieve a high culture-positive rate (84.6%).
  • Long-term, culture-specific antibiotic/antifungal treatment leads to improved clinical outcomes.