Clark Matthew P A, Pretorius Pieter M, Byren Ivor, Milford Chris A
ENT Department, Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Skull Base. 2009 Jul;19(4):247-54. doi: 10.1055/s-0028-1115325.
We report cases of central or atypical skull base osteomyelitis and review issues related to the diagnosis and treatment.
The four cases presented, which were drawn from the Oxford, United Kingdom, skull base pathology database, had a diagnosis of central skull base osteomyelitis.
Four cases are presented in which central skull base osteomyelitis was diagnosed. Contrary to malignant otitis externa, our cases were not preceded by immediate external infections and had normal external ear examinations. They presented with headache and a variety of cranial neuropathies. Imaging demonstrated bone destruction, and subsequent microbiological analysis diagnosed infection and prompted prolonged antibiotic treatment.
We concluded that in the diabetic or immunocompromised patient, a scenario of headache, cranial neuropathy, and bony destruction on imaging should raise the possibility of skull base osteomyelitis, even in the absence of an obvious infective source. The primary goal should still be to exclude an underlying malignant cause.
我们报告中枢性或非典型性颅底骨髓炎病例，并回顾与诊断和治疗相关的问题。
所呈现的4例病例取自英国牛津颅底病理数据库，均诊断为中枢性颅底骨髓炎。
呈现4例诊断为中枢性颅底骨髓炎的病例。与恶性外耳道炎不同，我们的病例之前没有直接的外部感染，且外耳道检查正常。他们表现为头痛和各种颅神经病变。影像学显示骨质破坏，随后的微生物学分析诊断为感染，并促使进行长期抗生素治疗。
我们得出结论，在糖尿病或免疫功能低下的患者中，即使没有明显的感染源，出现头痛、颅神经病变和影像学上的骨质破坏情况，也应提高颅底骨髓炎的可能性。首要目标仍应是排除潜在的恶性病因。
