Cranial Osteomyelitis: A Comprehensive Review of Modern Therapies

Mortazavi, Martin M.; Khan, Muhammad Adnan; Quadri, Syed A.; Suriya, Sajid; Fahimdanesh, Kian M.; Fard, Salman Abbasi; Hassanzadeh, Tania; Taqi, M; Grossman, Hannah G.; Tubbs, R. Shane

doi:10.1016/j.wneu.2017.12.066

Cited by 55 publications

(61 citation statements)

References 145 publications

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“…In developed nations, postoperative craniotomy infections are the predominant source. [ 12 18 19 20 21 ]…”

Section: Discussionmentioning

confidence: 99%

“…Many cases of cranial osteomyelitis have been reported from posttraumatic injuries secondary to minor scalp wounds such as human bites, scalp wound/laceration, and needle insertions. [ 19 40 41 ] Other direct injuries causing cranial osteomyelitis include cephalohematoma infection (particularly after vacuum extraction), craniofacial injuries, penetrating craniocerebral injury, traumatic scalp hematoma, and contaminated war wounds. [ 42 43 44 45 46 47 ]…”

Section: Discussionmentioning

confidence: 99%

“…Despite these advancements, SBO remains a great challenge, due to its increasing prevalence and high mortality rate. [ 11 12 13 14 15 16 17 18 19 ] In this review article, the epidemiology, clinical course, and diagnostic and therapeutic challenges for the management of SBO are examined. The aim of this review is to increase physician awareness of SBO by highlighting its clinical features and diagnostic modalities and emphasizing the potentially devastating complications.…”

Section: Introductionmentioning

confidence: 99%

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A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Khan¹,

Quadri²,

et al. 2018

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Skull base osteomyelitis (SBO) is a complex and fatal clinical entity that is often misdiagnosed for malignancy. SBO is commonly a direct complication of otogenic, sinogenic, odontogenic, and rhinogenic infections and can present as central, atypical, or pediatric clival SBO. This review describes the clinical profile, investigational approach, and management techniques for these variants. A comprehensive literature review was performed in PubMed, MEDLINE, Research Gate, EMBASE, Wiley Online Library, and various Neurosurgical and Neurology journals with the keywords including: SBO, central or atypical SBO, fungal osteomyelitis, malignant otitis externa, temporal bone osteomyelitis, and clival osteomyelitis. Each manuscript's reference list was reviewed for potentially relevant articles. The search yielded a total of 153 articles. It was found that with early and aggressive culture guided long-term intravenous broad-spectrum antibiotic therapy decreases post-infection complications. In cases of widespread soft tissue involvement, an early aggressive surgical removal of infectious sequestra with preferentially Hyperbaric Oxygen (HBO) therapy is associated with better prognosis of disease, less neurologic sequelae and mortality rate. Complete resolution of the SBO cases may take several months. Since early treatment can improve mortality rates, it is paramount that the reporting radiologists and treating clinicians are aware of the cardinal diagnostic signs to improve clinical outcomes of the disease. It will decrease delayed diagnosis and under treatment of the condition. However, due to rarity of the condition, complete prognostic factors have not fully been analyzed and discussed in the literature.

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“…In developed nations, postoperative craniotomy infections are the predominant source. [ 12 18 19 20 21 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Khan¹,

Quadri²,

et al. 2018

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“…Rarely, cranial osteomyelitis can occur following head trauma (common in children) and after neurosurgical procedures. [222324] Our study group had only 1 patient with post-traumatic SBO.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and complications of skull base osteomyelitis: A 12-year study in a teaching hospital in South India

Das

Iyadurai

Gunasekaran

et al. 2019

J Family Med Prim Care

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Context: Skull base osteomyelitis (SBO) is an uncommon disease with substantial morbidity and mortality. Aims: The aim of this study is to characterize clinical features, outcomes, and complications of SBO. We also looked at differences in clinical profile in otogenic and non-otogenic SBO. Materials and Methods: This is a single-center retrospective observational study. Patients aged more than 15 years of age with clinical and radiological diagnosis of SBO admitted in general medicine department in a teaching hospital in South India from March 2006 to February 2018 were recruited. Results: A total of 41 patients with SBO were identified and included. Mean age was 56.9 ± 10.7 years. In all, 90% of patients (37/41) had diabetes mellitus and 29% (12/41) had recent head/neck surgery. Only 19% (8/41) needed ICU care, and mortality was 21% (9/41). Most common symptom was headache seen in 73% (30/41) of patients. Majority, 61% (25/41), had otogenic infections. Otogenic infections were associated with longer duration of diabetes mellitus (mean = 11.5 vs. 5 years, P = 0.01), higher creatinine levels (mean = 1.66 vs. 0.9 mg/dL, P = 0.014, odds ratio [OR] = 3.8), and higher incidence of cranial nerve palsy (92% vs. 56%; OR = 8.9) compared to non-otogenic SBO. Cranial nerve palsy (78%), meningitis (63%), and cerebral venous thrombosis (43%) were frequent complications of SBO in this study. The causative organisms for SBO in our cohort was bacterial in 60% (15/25) and fungal in 40% (10/25) of the patients. Surgical debridement for source control was done in 54% of patients (22/41) and was associated with survival at discharge ( P = 0.001). Conclusions: Bacterial infections are the most common cause of SBO. Otogenic SBO is associated with longer duration of diabetes mellitus and higher incidence of cranial nerve palsy. Therapeutic surgical debridement plays an important role in treatment of SBO and is associated with improved survival.

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“…Skull base osteomyelitis is a rare condition,1 that usually develops after a local sinus infection or a significant otitis 2. In addition to this contiguous spread, haematological spread is also reported.…”

Section: Discussionmentioning

confidence: 99%

Insidious onset of headache, diplopia and Horner’s syndrome: a rare case of petrous bone osteomyelitis

Biart¹,

Panicker

2019

BMJ Case Rep

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We present an unusual case of skull base osteomyelitis in an 88-year-old woman. She presented with gradual onset unilateral headache and diplopia. On examination, there was evidence of a left-sided Horner’s and ipsilateral sixth nerve palsy. In addition to persistent raised inflammatory markers, an MRI neck identified signal change in the petrous bone confirming a diagnosis of skull base osteomyelitis. Skull base osteomyelitis should be considered in presentations of subacute raised inflammatory markers in the context of ipsilateral cranial nerve signs.

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Cranial Osteomyelitis: A Comprehensive Review of Modern Therapies

Cited by 55 publications

References 145 publications

A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

A comprehensive review of skull base osteomyelitis: Diagnostic and therapeutic challenges among various presentations

Clinical characteristics and complications of skull base osteomyelitis: A 12-year study in a teaching hospital in South India

Insidious onset of headache, diplopia and Horner’s syndrome: a rare case of petrous bone osteomyelitis

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