Osteomyelitis of the Temporal Bone: Terminology, Diagnosis, and Management
Abstract Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the te...
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| Published in | Journal of neurological surgery. Part B, Skull base Vol. 75; no. 5; pp. 324 - 331 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Stuttgart · New York
Georg Thieme Verlag KG
01.10.2014
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Abstract
Objectives
To review the terminology, clinical features, and management of temporal bone osteomyelitis.
Design and Setting
Prospective study in a tertiary care center from 2001 to 2008.
Participants
Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone.
Main Outcome Measures
The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed.
Results
Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were
Pseudomonas aeruginosa
(80%) and
Staphylococcus aureus
(13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%).
Conclusion
A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. |
|---|---|
| AbstractList | Abstract
Objectives
To review the terminology, clinical features, and management of temporal bone osteomyelitis.
Design and Setting
Prospective study in a tertiary care center from 2001 to 2008.
Participants
Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone.
Main Outcome Measures
The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed.
Results
Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were
Pseudomonas aeruginosa
(80%) and
Staphylococcus aureus
(13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%).
Conclusion
A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology.Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology. |
| Author | Prasad, Sampath Chandra Prasad, Kishore Chandra Rao, Pallavi Kumar, Abhijit Thada, Nikhil Dinaker Chalasani, Satyanarayana |
| AuthorAffiliation | 2 Department of Radiodiagnosis, Kasturba Medical College, Mangalore (Manipal University), Mangalore, Karnataka, India 1 Department of Otolaryngology – Head & Neck Surgery, Kasturba Medical College, Mangalore (Manipal University), Mangalore, Karnataka, India |
| AuthorAffiliation_xml | – name: 1 Department of Otolaryngology – Head & Neck Surgery, Kasturba Medical College, Mangalore (Manipal University), Mangalore, Karnataka, India – name: 2 Department of Radiodiagnosis, Kasturba Medical College, Mangalore (Manipal University), Mangalore, Karnataka, India |
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| Cites_doi | 10.1016/j.ijporl.2005.03.036 10.1017/S0022215112002356 10.2106/00004623-197658080-00020 10.1016/S0196-0709(97)90043-0 10.1177/014556139407301009 10.1288/00005537-195910000-00006 10.2500/ajr.2007.21.3033 10.1177/000348948008900109 10.1288/00005537-198605000-00014 10.1007/s00405-005-0998-y 10.1080/00016480510038158 10.1080/00016480600818054 10.1288/00005537-198603000-00003 10.3109/00016489609137954x 10.1177/000348948909800912 10.1046/j.1365-2273.1997.00032.x 10.1288/00005537-196808000-00002 10.1017/S0022215106002775 10.1093/infdis/161.3.537 10.1017/S0022215100134929 10.1177/019459989310900407 10.1288/00005537-198912000-00002 |
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| References | S E Kountakis (ref16) 1997; 18 K C Prasad (ref4) 2007; 127 O Cavel (ref26) 2007; 21 J R Chandler (ref8) 1989; 10 S G Gherini (ref19) 1986; 96 M Dudkiewicz (ref6) 2005; 69 J M Bernstein (ref27) 2007; 121 J R Chandler (ref5) 1986; 96 T H Yang (ref15) 2006; 263 J E Benecke Jr (ref21) 1989; 99 P C Chang (ref20) 2003; 24 J T Mader (ref28) 1982; 108 R H Fitzgerald Jr (ref1) 1976; 58 P E Meltzer (ref2) 1959; 169 P V Driscoll (ref11) 1993; 109 W Anderhuber (ref12) 1995; 74 J D Hern (ref9) 1996; 110 V G Schweitzer (ref14) 1990; 11 R Lang (ref24) 1990; 161 L Amorosa (ref18) 1996; 521 S E Weinroth (ref13) 1994; 73 J R Chandler (ref3) 1968; 78 E Ostfeld (ref7) 1980; 89 C P Kimmelman (ref22) 1989; 98 H B Pedersen (ref23) 1997; 22 P Walshe (ref10) 2002; 95 A Sethi (ref17) 2005; 125 P M Spielmann (ref25) 2013; 127 |
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Objectives
To review the terminology, clinical features, and management of temporal bone osteomyelitis.
Design and Setting
Prospective study in a... Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care... Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care... Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary... |
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| Title | Osteomyelitis of the Temporal Bone: Terminology, Diagnosis, and Management |
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