PDF(Pubmed)
Abstract：
Skull base osteomyelitis is a vicious infection of temporal bone associated with very high morbidity and mortality. But few studies have been undertaken recently for eliciting its increasing incidence. Hence this study aims to describe the clinical profile of skull base osteomyelitis and changes noted in the post-covid period, and encourage a uniform treatment policy globally. This descriptive study was conducted among 140 patients diagnosed with skull base osteomyelitis. Data was collected using semi-structured proforma, HRCT temporal bone findings, microbiological reports, histopathology of granulation tissue, ESR and House-Brackmann grading. Male patients in 61-70 age group were most commonly affected and all patients had uncontrolled diabetes mellitus, usually presenting with nocturnal otalgia, ear canal granulation and cranial nerve palsy. Pseudomonas aeruginosa was the most common isolate followed by Staphylococcus aureus. Among fungal pathogens, candida albicans were the most common. 29.3% patients had extensive disease according to Thakar et al. staging and on follow up, 43.75% patients showed a satisfactory response. Coronary artery disease and cerebrovascular accidents were the leading cause of death. More atypical organisms, extensive disease and changes in antibiotic sensitivity were noted in the post-covid period. Prolonged treatment with culture sensitive antibiotic is the main stay of treatment. A uniform treatment guideline is needed for proper management of such patients. Level of Evidence 4.
摘要：
颅底骨髓炎是颞骨的恶性感染，发病率和死亡率很高。但是最近很少有研究导致其发病率增加。因此，这项研究旨在描述颅底骨髓炎的临床概况和在covid后时期注意到的变化，并鼓励全球统一的治疗政策。这项描述性研究是在140例诊断为颅底骨髓炎的患者中进行的。数据是使用半结构化形式收集的，颞骨HRCT发现,微生物报告，肉芽组织的组织病理学，ESR和House-Brackmann分级。61-70岁年龄组的男性患者最常见，所有患者均患有未控制的糖尿病，通常表现为夜间耳痛，耳道肉芽和颅神经麻痹。铜绿假单胞菌是最常见的分离株，其次是金黄色葡萄球菌。在真菌病原体中，白色念珠菌是最常见的。根据Thakar等人，29.3％的患者患有广泛疾病。分期和后续行动，43.75％的患者表现出满意的反应。冠状动脉疾病和脑血管意外是死亡的主要原因。更多的非典型生物，在covid后期间，发现了广泛的疾病和抗生素敏感性的变化。培养敏感性抗生素的长期治疗是治疗的主要停留。需要统一的治疗指南来正确管理此类患者。证据水平4。
