Skull base osteomyelitis secondary to malignant otitis externa mimicking advanced nasopharyngeal cancer: MR imaging features at initial presentation

Otitis externa affects both children and adults. It is often treated with topical antibiotics, with good clinical outcomes. When a patient fails to respond to the treatment, otitis externa can progress to malignant otitis externa. The common symptoms of skull bone osteomyelitis include ear ache, facial pain, and cranial nerve palsies. However, an isolated cranial nerve is rare. Herein, we report a case of 54-year-old female who presented with left cranial nerve VI palsy due to skull base osteomyelitis which responded to antibiotic therapy.

Download Full-text

Diffusion MR Imaging Features of Skull Base Osteomyelitis Compared with Skull Base Malignancy

American Journal of Neuroradiology ◽

10.3174/ajnr.a2237 ◽

2010 ◽

Vol 32 (1) ◽

pp. 179-184 ◽

Cited By ~ 33

Author(s):

B. Ozgen ◽

K.K. Oguz ◽

A. Cila

Keyword(s):

Mr Imaging ◽

Skull Base ◽

Imaging Features ◽

Skull Base Osteomyelitis ◽

Diffusion Mr ◽

Diffusion Mr Imaging

Download Full-text

Malignant otitis externa with skull base osteomyelitis

Journal of Surgical Case Reports ◽

10.1093/jscr/2011.5.6 ◽

2011 ◽

Vol 2011 (5) ◽

pp. 6-6 ◽

Cited By ~ 4

Author(s):

E Illing ◽

M Zolotar ◽

E Ross ◽

O Olaleye ◽

N Molony

Keyword(s):

Skull Base ◽

Otitis Externa ◽

Skull Base Osteomyelitis ◽

Malignant Otitis Externa

Download Full-text

Diffusion MR Imaging Features of Skull Base Osteomyelitis Compared with Skull Base Malignancy

Yearbook of Diagnostic Radiology ◽

10.1016/j.yrad.2011.03.008 ◽

2011 ◽

Vol 2011 ◽

pp. 323-325

Author(s):

A.G. Osborn

Keyword(s):

Mr Imaging ◽

Skull Base ◽

Imaging Features ◽

Skull Base Osteomyelitis ◽

Diffusion Mr ◽

Diffusion Mr Imaging

Download Full-text

Skull Base Osteomyelitis: Diagnostic and Therapeutic Challenges in Atypical Presentation

Otolaryngology ◽

10.1016/j.otohns.2005.03.024 ◽

2005 ◽

Vol 133 (1) ◽

pp. 121-125 ◽

Cited By ~ 53

Author(s):

Amar Singh ◽

Mazin Al Khabori

Keyword(s):

Skull Base ◽

Cranial Nerve ◽

Otitis Externa ◽

Cranial Nerves ◽

Contralateral Side ◽

Lateral Sinus ◽

Skull Base Osteomyelitis ◽

Atypical Symptoms ◽

Malignant Otitis Externa ◽

Atypical Manifestations

OBJECTIVE: We sought to document the diagnostic and management difficulties in masked skull base osteomyelitis secondary to malignant otitis externa, with emphasis on establishing diagnostic criteria in recurrence. STUDY DESIGN: Retrospective analysis of 3 cases of inadequately treated malignant otitis externa in elderly diabetic individuals leading to recurrence and atypical manifestations of skull base osteomyelitis on contralateral side with or without multiple cranial nerve involvement. RESULTS: Two of the 3 cases died of the disease despite aggressive treatment. One case was treated successfully with combination of antipsuedamonal microbial drugs for 8 to 12 weeks and hyperbaric oxygen therapy. Major complications such as thrombosis of lateral sinus and internal jugular vein, meningitis, ophthalmoplegia, blindness, cervical spine erosion and paralysis of all cranial nerves with exception of Ist cranial nerve were observed. CONCLUSION: There is high morbitity and mortality associated with skull base osteomyelitis. In partially treated cases of malignant otitis externa, atypical symptoms and findings of unilateral severe otalgia, unremitting headache, and presence of high ESR, unilateral OME, constitute diagnostic clues of skull base osteomyelitis. Such cases require further investigation with CT, MRI, Technetium 99 and gallium 67 scintigraphy and aggressive management.

Download Full-text