title: Skull base osteomyelitis missed in mastoidectomy for cholesteatoma.
abstract: Conclusions A high suspicion of skull base involvement should be warranted, even if radiological findings are not atypical, in cases of chronic otitis media (COM) with cholesteatoma. Objective To investigate some clues indicating the development of skull base osteomyelitis (SBO) in patients who received mastoidectomy, through reviewing pre-operative temporal bone computed tomography (TBCT). Method Retrospective review of patients with SBO after mastoidectomy for COM. A total of five patients with SBO after mastoidectomy with available pre-operative TBCTs were enrolled in this study. Results All patients were diagnosed as COM with cholesteatoma and open cavity mastoidectomy was performed. After surgery, SBO were occurred. The recovery in these five patients was complicated by lower cranial nerve palsy, and one patient had a stroke due to lateral thrombophlebitis. Through re-interpretation of pre-operative TBCT, the bony destruction around the skull base missed at the initial diagnosis was observed in all cases.
authors.affiliation: a Department of Otolaryngology , University of Ulsan College of Medicine , Seoul , Republic of Korea ;
authors.forename: Hwan Seo
authors.initials: HS
authors.lastname: Lee
authors.affiliation: a Department of Otolaryngology , University of Ulsan College of Medicine , Seoul , Republic of Korea ;
authors.forename: Chan Joo
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: b Department of Radiology, Asan Medical Center , University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: a Department of Otolaryngology , University of Ulsan College of Medicine , Seoul , Republic of Korea ;
authors.forename: Joong Ho
authors.initials: JH
authors.lastname: Ahn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018424:Cholesteatoma, Middle Ear / Q000150:complications* / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000209:etiology*; D010033:Otitis Media / Q000150:complications*; D012189:Retrospective Studies; D019291:Skull Base; D013701:Temporal Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Skull base osteomyelitis; cholesteatoma; mastoidectomy