Abstract
Purpose
Skull base osteomyelitis (SBO) is an uncommon and a potentially life-threatening condition if not promptly recognized and properly treated. The aim of our study was to present a 32-case series of patients diagnosed with SBO at a single center.
Methods
In this retrospective study, we reviewed the data of patients diagnosed with otogenic SBO between January 2011 and January 2020. 32 patients were enrolled in the study. SBO diagnosis was based on a combination of symptoms and physical examination, bone scan, brain magnetic resonance imaging, and pathologic examination findings. The following clinical data were collected during the follow-up period: types of antibiotics used, duration of antibiotic treatment, C-reactive protein level, presence of disease control, duration from the onset of symptoms to diagnosis, and patient survival.
Results
The mean follow-up period was 11 (1–110) months. The mean duration of antibiotic treatment was 115 (19–223) days. The mean C-reactive protein levels at the time of diagnosis and at the endpoint of follow-up were 3.05 (0.56–18.31) and 0.21 (0.03–33.61) mg/dL, respectively (P < 0.001). Disease control rate was 34.9% at 1-year and 83.7% at 5-year follow-up. Patient survival rate was 90.6% at 1- and 3-year follow-ups. At the endpoint of follow-up, three patients died. The mean durations from the onset of symptoms to diagnosis were 50 (5–360) and 90 (30–480) days in patients with the controlled disease and in those with the uncontrolled disease, respectively, at the endpoint of follow-up (P = 0.043).
Conclusion
Comprehensive assessment and aggressive treatment of patients exhibiting symptoms suggestive of SBO would help in the rapid diagnosis of otogenic SBO, resulting in an improvement in prognosis.
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Funding
Funding was provided by the National Research Foundation of Korea grant funded by the Korean government (Grant No. 2018R1C1B6007775).
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DJJ contributed to the conception and design of the study. DJJ and MHY contributed to the acquisition and analysis of data. DJJ and KYL contributed to the interpretation of data. KYL contributed to the drafting of the article or critically revising it for important intellectual content. All authors approved the final version of the manuscript to be submitted.
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The authors declare that they have no conflict of interest to disclose.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Kyungpook National University Hospital Institutional Review Board; approval No. Knuh 2019-10-044) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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The board waived the need for informed consent because the subjects’ records and information were anonymized and de-identified prior to the analysis. The study was conducted in accordance with the principles that have their origin in the Declaration of Helsinki.
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Jung, D.J., Hong, J., Cho, H.J. et al. Clinical outcomes of otogenic skull base osteomyelitis. Eur Arch Otorhinolaryngol 278, 2817–2822 (2021). https://doi.org/10.1007/s00405-020-06366-0
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DOI: https://doi.org/10.1007/s00405-020-06366-0