Chandler J R, Grobman L, Quencer R, Serafini A
Laryngoscope. 1986 Mar;96(3):245-51. doi: 10.1288/00005537-198603000-00003.
Infection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well-developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long-term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.
颞骨、枕骨和蝶骨骨髓感染虽不常见，但有增多趋势。它通常继发于外耳道起始的感染，几乎均由革兰氏阴性铜绿假单胞菌引起。锝和镓闪烁扫描有助于此类感染的早期检测，而CT扫描在病情发展成熟的病例中可显示骨质溶解。头痛是主要症状。吞咽困难、声音嘶哑和误吸预示着颅神经不可避免地受累。我们已诊断并治疗了17例颅底骨髓炎。尽管总死亡率为53%，但它现在是一种可治愈的疾病。我们最近的8例患者中有6例存活，尽管有1例仍在治疗中。治疗采用药物治疗，需要长期联合静脉注射一种氨基糖苷类药物和一种对致病生物有效的广谱半合成青霉素。
