Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.

Abstract

Conclusions A high suspicion of skull base involvement should be warranted, even if radiological findings are not atypical, in cases of chronic otitis media (COM) with cholesteatoma. Objective To investigate some clues indicating the development of skull base osteomyelitis (SBO) in patients who received mastoidectomy, through reviewing pre-operative temporal bone computed tomography (TBCT). Method Retrospective review of patients with SBO after mastoidectomy for COM. A total of five patients with SBO after mastoidectomy with available pre-operative TBCTs were enrolled in this study. Results All patients were diagnosed as COM with cholesteatoma and open cavity mastoidectomy was performed. After surgery, SBO were occurred. The recovery in these five patients was complicated by lower cranial nerve palsy, and one patient had a stroke due to lateral thrombophlebitis. Through re-interpretation of pre-operative TBCT, the bony destruction around the skull base missed at the initial diagnosis was observed in all cases.

• Authors: Hwan Seo Lee, Chan Joo Yang, Jeong Hyun Lee, Joong Ho Ahn
• Journal: Acta oto-laryngologica (Acta Otolaryngol) Vol. 136 Issue 3 Pg. 256-8 ( 2016) ISSN: 1651-2251 [Electronic] England
• PMID: 26767507 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Cholesteatoma, Middle Ear (complications, surgery)
• Chronic Disease
• Female
• Humans
• Male
• Middle Aged
• Osteomyelitis (diagnostic imaging, etiology)
• Otitis Media (complications)
• Retrospective Studies
• Skull Base
• Temporal Bone (diagnostic imaging)
• Tomography, X-Ray Computed