Skull Base Osteitis: Our Experience and Systematic Review of Literature

Abstract

Objective: This article discusses etiopathogenesis, diagnostic problems and various
management modalities available to manage skull base ostietis (SBO) which is a rare but life
threatening disorder and in addition national and international references will be reviewed.
Material and Methods: Cross sectional, retrospective study carried out at ENT unit-I
SIMS/SHL which included 17 patients with SBO which were sorted out for etiological diagnosis
based on detailed history, physical examination and labs.
Results: Mean age was 52 years. Diabetes is the most significant risk factor and was seen in
82% of patients, pseudomonas was isolated in 8 patients. The main complication facial paralysis
was present in 64% of patients.
Conclusion: SBO remains a severe debilitating and life-threatening condition. It may develop in
patients with benign otitis media and externa, and must be considered in all patients with temporal
bone inflammation; especially those with risk factors and those who fail to improve with more
conservative measures. Small-vessel vasculopathy and immune dysfunction associated with
diabetes are primarily responsible for this predisposition. Cranial nerves most commonly the
facial, can be affected by inflammation along the skull base or by a neurotoxin produced by
Pseudomonas species. We, in this article, intend to share our experience in managing seventeen
patients with SBO over a period of three years and review the relevant and recent global literature
suggesting updates.