Atypical osteomyelitis of the skull Base

ABSTRACT

The authors reporetd six cases of atypical osteomyelitis of the skull base in diabetic patients. They were studied clinically, radiologically and pathologically. This disease may arise without intial temporal bone affection or may complicate incompletely treated malignant otitis externa. Spread of the disease may occur through vascular involvement of the skull bones and fascial planes rather than through the air cells. The ethmoid the sphenoid and occipital bones are affected beside the temporal bones and the petrous apex. Multiple cranial nerves may be affected including the 2nd, 3rd, 4th, 5th, 9th and 10th nerves and the disease may present as the jugular foramen or the orbital apex syndromes. The morbidity and the mortality of the disease is higher in patients without previous temporal bone affection because it is usually not promptly recognized and treated