Osteomyelitis of the Temporal Bone

Terminology, Diagnosis, and Management

Sampath Chandra Prasad, Kishore Chandra Prasad, Abhijit Kumar, Nikhil Dinaker Thada, Pallavi Rao, Satyanarayana Chalasani

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology.

Original languageEnglish
Pages (from-to)324-331
Number of pages8
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume75
Issue number5
DOIs
Publication statusPublished - 26-06-2014
Externally publishedYes

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Temporal Bone
Osteomyelitis
Terminology
Otitis Media
Intractable Pain
Facial Paralysis
Facial Nerve
Debridement
Radiology
Tertiary Care Centers
Pseudomonas aeruginosa
Ear
Staphylococcus aureus
Diabetes Mellitus
Outpatients
Therapeutics
Outcome Assessment (Health Care)
Prospective Studies
Anti-Bacterial Agents
Inflammation

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Prasad, Sampath Chandra ; Prasad, Kishore Chandra ; Kumar, Abhijit ; Thada, Nikhil Dinaker ; Rao, Pallavi ; Chalasani, Satyanarayana. / Osteomyelitis of the Temporal Bone : Terminology, Diagnosis, and Management. In: Journal of Neurological Surgery, Part B: Skull Base. 2014 ; Vol. 75, No. 5. pp. 324-331.
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abstract = "Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10{\%}) were diagnosed as acute otitis media. Eighteen (90{\%}) had chronic otitis media. Nineteen (95{\%}) were classified as medial temporal bone osteomyelitis and one (5{\%}) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100{\%}), pain (83{\%}), and granulations (100{\%}). Facial nerve palsy was seen in seven cases (35{\%}) and parotid involvement in one case. Ten patients (56{\%}) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80{\%}) and Staphylococcus aureus (13.33{\%}). Histopathology revealed chronic inflammation in 20 patients (100{\%}) and osteomyelitic bony changes in 14 (70{\%}). Surgical debridement was the most preferred modality of treatment (87{\%}). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology.",
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Osteomyelitis of the Temporal Bone : Terminology, Diagnosis, and Management. / Prasad, Sampath Chandra; Prasad, Kishore Chandra; Kumar, Abhijit; Thada, Nikhil Dinaker; Rao, Pallavi; Chalasani, Satyanarayana.

In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 75, No. 5, 26.06.2014, p. 324-331.

Research output: Contribution to journalArticle

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AB - Objectives To review the terminology, clinical features, and management of temporal bone osteomyelitis. Design and Setting Prospective study in a tertiary care center from 2001 to 2008. Participants Twenty patients visiting the outpatient department diagnosed with osteomyelitis of the temporal bone. Main Outcome Measures The age, sex, clinical features, cultured organisms, surgical interventions, and classification were analyzed. Results Of the 20 cases, 2 (10%) were diagnosed as acute otitis media. Eighteen (90%) had chronic otitis media. Nineteen (95%) were classified as medial temporal bone osteomyelitis and one (5%) as lateral temporal osteomyelitis. The most common clinical features were ear discharge (100%), pain (83%), and granulations (100%). Facial nerve palsy was seen in seven cases (35%) and parotid involvement in one case. Ten patients (56%) had diabetes mellitus. The organisms isolated were Pseudomonas aeruginosa (80%) and Staphylococcus aureus (13.33%). Histopathology revealed chronic inflammation in 20 patients (100%) and osteomyelitic bony changes in 14 (70%). Surgical debridement was the most preferred modality of treatment (87%). Conclusion A new classification of temporal bone osteomyelitis has been proposed. Bacterial cultures must be performed in all patients. Antibiotic therapy is the treatment of choice. Surgical intervention is necessary in the presence of severe pain, complications, refractory cases, or the presence of bony sequestra on radiology.

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