Korean J Otorhinolaryngol-Head Neck Surg.  2014 Jul;57(7):489-492. 10.3342/kjorl-hns.2014.57.7.489.

A Case of Central Skull Base Osteomyelitis Concurrent with Multiple Lower Cranial Nerve Palsies

• Kwak SG
• Sah DJ
• Kim YJ
• Kim SW

• KMID: 2277921
• DOI: http://doi.org/10.3342/kjorl-hns.2014.57.7.489

Abstract

In most cases, skull base osteomyelitis arises from infections of external auditory canal, middle ear or paranasal sinuses. On the other hand, atypical or central skull base osteomyelitis has no evidence of external otitis or other infection sources. It is often found located on clivus and involves lower cranial nerves and brainstem through the foramina of skull base. The overall rate of mortality reaches 10% and long-term neurologic sequelae are seen in additional 31% of cases regardless of aggressive treatment. We recently encountered a 68-year-old man with right facial pain and generalized headache, and we achieved good outcome with the recovery of vocal cord palsy and disappearance of headache by surgical debridement and long-term antibiotics. We report it with a review of literature.

Keyword

Multiple cranial neuropathy; Osteomyelitis; Skull base

MeSH Terms

Aged
Anti-Bacterial Agents
Brain Stem
Cranial Fossa, Posterior
Cranial Nerve Diseases*
Cranial Nerves
Debridement
Ear Canal
Ear, Middle
Facial Pain
Hand
Headache
Humans
Mortality
Osteomyelitis*
Otitis Externa
Paranasal Sinuses
Skull Base*
Vocal Cord Paralysis
Anti-Bacterial Agents