Skull base infection presenting with multiple lower cranial nerve palsies

Patmore, Harriet; Jebreel, Ala; Uppal, Sandeep; Raine, Chris; McWhinney, Paul

doi:10.1016/j.amjoto.2009.04.001

Cited by 48 publications

(46 citation statements)

References 32 publications

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“…These results are not surprising given the degree of swallowing dysfunction previously reported among long‐term OPC survivors in earlier case reports, which suggested that treatment‐related LCNP may play a major role in late RAD and precipitate delayed but extreme oropharyngeal impairment as recorded by MBS studies . These observations also align to numerous reports of significant swallowing dysfunction caused by lower CN deficits among populations (in the absence of head and neck RT) due to traumatic injury, vascular causes, and infection, documented primarily in case reports …”

Section: Discussionsupporting

confidence: 82%

Swallowing‐related outcomes associated with late lower cranial neuropathy in long‐term oropharyngeal cancer survivors: cross‐sectional survey analysis

et al. 2019

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Background The purpose of this study was to quantify the association of late lower cranial neuropathy (late LCNP) with swallowing‐related quality of life (QOL) and functional status among long‐term oropharyngeal cancer (OPC) survivors. Methods Eight hundred eighty‐nine OPC survivors (median survival time: 7 years) who received primary treatment at a single institution between January 2000 and December 2013 completed a cross‐sectional survey (56% response rate) that included the MD Anderson Dysphagia Inventory (MDADI) and self‐report of functional status. Late LCNP events ≥3 months after cancer therapy were abstracted from medical records. Multivariate models regressed MDADI scores on late LCNP status adjusting for clinical covariates. Results Overall, 4.0% (n = 36) of respondents developed late LCNP with median time to onset of 5.25 years post‐treatment. LCNP cases reported significantly worse mean composite MDADI (LCNP: 68.0 vs no LCNP: 80.2; P < .001). Late LCNP independently associated with worse mean composite MDADI (β = −6.7, P = .02; 95% confidence interval [CI], −12.0 to −1.3) as well as all MDADI domains after multivariate adjustment. LCNP cases were more likely to have a feeding tube at time of survey (odds ratio [OR] = 20.5; 95% CI, 8.6‐48.9), history of aspiration pneumonia (OR = 23.5; 95% CI, 9.6‐57.6), and tracheostomy (OR = 26.9; 95% CI, 6.0‐121.7). Conclusions In this large survey study, OPC survivors with late LCNP reported significantly poorer swallowing‐related QOL and had significantly higher likelihood of poor functional status. Further efforts are necessary to optimize swallowing outcomes to improve QOL in this subgroup of survivors.

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Section: Discussionsupporting

confidence: 82%

Swallowing‐related outcomes associated with late lower cranial neuropathy in long‐term oropharyngeal cancer survivors: cross‐sectional survey analysis

et al. 2019

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“…The designation of SBO is a contentious issue. For some authors, the term necrotizing external otitis (NEO) is equivalent to osteomyelitis of the skull base, whereas others consider NEO to be a generic term, including soft tissue and bone lesions . In this study, we deliberately selected patients with radiologically documented osteitis as having SBO.…”

Section: Discussionmentioning

confidence: 99%

Skull base osteomyelitis: Incidence of resistance, morbidity, and treatment strategy

et al. 2014

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“…Central skull base osteomyelitis is a rare disease and generally accompanied by a headache and CN palsy . Moreover, it can be diagnosed with decreased T1 signal intensity and enhancement on MRI .…”

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confidence: 69%