# Understanding the Impact of Skull Base Osteomyelitis: A Retrospective Analysis of 14 Cases

## TL;DR

This study examines 14 cases of skull base osteomyelitis, focusing on symptoms, treatment effectiveness, and outcomes, particularly in diabetic patients.

## Contribution

The paper provides a detailed retrospective analysis of SBO cases, highlighting treatment resistance and rare complications like septic arthritis.

## Key findings

- All 14 patients were diabetic and presented with otalgia and purulent otorrhea.
- 21% of cases had facial palsy, and 14% developed septic arthritis of the temporomandibular joint.
- 43% of SBO cases showed resistance to ciprofloxacin, but all achieved disease resolution with combined treatment.

## Abstract

Purpose

Skull base osteomyelitis (SBO) or malignant otitis externa (MOE) is an invasive bacterial infection (a rarely fungal as well as potentially aggressive infection that involves the external auditory canal up to the temporal bone and skull base. This study provides insight into the various clinical presentations of skull base osteomyelitis, the effectiveness of different treatment approaches, and the overall prognosis of SBO based on our case series.

Materials and methods

This observational study comprises 14 SBO cases, including their diagnosis, follow-up, and treatment.

Results

Otalgia and purulent otorrhea were observed in all our cases as common symptoms. All patients were diabetic. Three cases (21%) presented with facial palsy and two cases (14%) reported a rare progression of SBO resulting in septic arthritis of the temporomandibular joint. In our study, 43% of the cases diagnosed with SBO had resistance to ciprofloxacin. All our patients had daily cleaning of the auditory canal and the application of antimicrobial ear drops along with long-term systemic antibiotic therapy followed by three weeks of oral antibiotic therapy. All our cases were reviewed after three weeks. Resolution of the disease was achieved.

Conclusion

Early diagnosis, good control of blood glucose levels, prolonged medical management, and local debridement are likely to result in a better prognosis for patients.