Simon Miriam, Dreyer Sven, Joost Insa, Rubbert Christian, Schipper Jörg, Kristin Julia
Department of Otorhinolaryngology, Duesseldorf University Hospital, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Department of Orthopedics and Trauma Surgery, Duesseldorf University Hospital, Moorenstrasse 5, 40225, Duesseldorf, Germany.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):1835-1842. doi: 10.1007/s00405-024-09081-2. Epub 2024 Nov 29.
Skull base osteomyelitis is a rare but potentially life-threatening disease. It usually occurs as a complication of severe otitis externa or infection in the nasopharynx, often in immunocompromised patients. The therapeutic strategy is complex, patient-specific and requires interdisciplinary cooperation.
A retrospective evaluation of all patients with skull base osteomyelitis at the Department of Otorhinolaryngology of the University Hospital Duesseldorf from 2006 to 2023 was carried out. It was investigated which factors, in addition to treatment regimens (antibiotic therapy with i.v./oral antibiotics, surgical debridement and HBO therapy) have an influence on the clinical, laboratory and morphological outcome of the patients.
A total of 42 patients who received interdisciplinary treatment in our clinic were included in the study, of whom 71.4% were male and 28.6% female. The tissue samples showed an inflammatory process, with detection of Pseudomonas aeruginosa in 68.4% of patients. A total of 61.9% of patients presented cranial nerve deficits, most frequently facial nerve palsy. A total of 66.7% of patients received HBO therapy. Of these, n = 20/23 patients (87%) with HBO improved and achieved regression in the follow-up imaging. Known patient-specific factors were confirmed and HBO was emphasized as an important component of the multimodal therapy concept. HBO appears to be justified and should continue to be included in the treatment regimen in the future. For this reason, patients with SBO should be sent to a center that offers HBO therapy.
颅底骨髓炎是一种罕见但可能危及生命的疾病。它通常作为严重外耳道炎或鼻咽部感染的并发症出现，常见于免疫功能低下的患者。治疗策略复杂，需因人而异，且需要多学科合作。
对2006年至2023年期间在杜塞尔多夫大学医院耳鼻喉科接受治疗的所有颅底骨髓炎患者进行了回顾性评估。研究了除治疗方案（静脉/口服抗生素治疗、手术清创和高压氧治疗）外，哪些因素会对患者的临床、实验室和形态学结果产生影响。
本研究纳入了在我们诊所接受多学科治疗的42例患者，其中71.4%为男性，28.6%为女性。组织样本显示有炎症过程，68.4%的患者检测到铜绿假单胞菌。共有61.9%的患者出现颅神经缺损，最常见的是面神经麻痹。共有66.7%的患者接受了高压氧治疗。其中，23例接受高压氧治疗的患者中有20例（87%）病情改善，在随访影像学检查中病情好转。已确认的患者个体因素得到证实，高压氧被强调为多模式治疗理念的重要组成部分。高压氧似乎是合理的，未来应继续纳入治疗方案。因此，患有颅底骨髓炎的患者应被送往提供高压氧治疗的中心。
