Kornilenko Liubov, Rocka Saulius, Balseris Svajunas, Arechvo Irina
Faculty of Medicine, Vilnius University, Ciurlionio 21/27, LT-03101 Vilnius, Lithuania.
Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Siltnamiu 29, LT-04130 Vilnius, Lithuania.
Case Rep Otolaryngol. 2017;2017:4097973. doi: 10.1155/2017/4097973. Epub 2017 Apr 9.
Temporal bone osteomyelitis is a serious life-threatening condition-a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Changing trends of the disease make a differential diagnosis difficult. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. Neoplasm and granulomatous inflammation were excluded by multiple biopsies. The disease can develop in nondiabetic patients. The disorder might be related to the initial inflammatory process in the middle ear with further direct spreading of infection through defects in the bony walls to deep temporal bone structures. Imaging should be performed early to detect osteolytic lesions of the skull base. Surgery was used for the presence of bone sequestra and infratemporal abscess.
颞骨骨髓炎是一种严重的危及生命的疾病，需要快速、准确的诊断以便开始治疗并降低发病率和死亡率。该疾病不断变化的趋势使得鉴别诊断变得困难。为强调临床怀疑这种危险疾病的重要性，现介绍我们处理三例疑难病例的经验。诊断基于临床症状、耳镜检查结果以及计算机断层扫描或磁共振成像的结果。通过多次活检排除了肿瘤和肉芽肿性炎症。该疾病可发生于非糖尿病患者。这种病症可能与中耳的初始炎症过程有关，感染通过骨壁缺损进一步直接蔓延至颞骨深部结构。应尽早进行影像学检查以检测颅底的溶骨性病变。对于存在骨死骨和颞下脓肿的情况则采用手术治疗。
