64 results match your criteria Skull Base Petrous Apex Infection

A Rare Complication of Chronic Otitis Media: Central Skull Base Osteomyelitis Managed With Combined Endoscopic Transmastoid and Transsphenoidal Debridement.

Otol Neurotol 2022 03;43(3):e344-e347

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.

Objective: This report describes a case of otogenic central skull base osteomyelitis (CSBO) requiring complex surgical intervention and reviews the literature on management of this entity.

Patient: A 76-year-old man presented with a nearly 20-year history of chronic otomastoiditis and cholesteatoma with ultimate progression to severe CSBO with involvement of the petrous apex, clivus, and craniocervical junction.

Interventions: CSBO was managed with culture-directed antibiotic therapy, hyperbaric oxygen, and surgical intervention including serial combined endoscopic transmastoid and transsphenoidal debridements. Read More

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Retrospective analysis of massive epistaxis and pseudoaneurysms in nasopharyngeal carcinoma after radiotherapy.

Eur Arch Otorhinolaryngol 2022 Jun 8;279(6):2973-2980. Epub 2021 Oct 8.

Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, No.17 Yongwaizheng Street, Nanchang, 330006, Jiangxi, China.

Objective: Epistaxis after radiotherapy for nasopharyngeal carcinoma (NPC) is a common clinical critical illness, which often leads to death of patients. This article focuses on the relationship between massive epistaxis and pseudoaneurysm after radiotherapy in patients with NPC and discusses clinically relevant treatment strategies.

Methods: A review was performed in 21 patients with massive epistaxis after radiotherapy for NPC from January 2011 to December 2019, and all of the patients were examined by computed tomography angiography (CTA). Read More

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Skull base osteomyelitis: Comprehensive analysis and a new clinicoradiological classification system.

Auris Nasus Larynx 2021 Oct 25;48(5):999-1006. Epub 2021 Feb 25.

Faculty of Medicine, Department of Otorhinolaryngology, Hacettepe University, Sıhhiye, Ankara Turkey.

Objective: Skull baseosteomyelitis (SBO) is a rare phenomenon that typically occurs in diabetic or immunocompromised patients, causing significant morbidity and mortality. This study aimed to analyze a single institution's treatment results in SBO patients and propose anew integrated clinicoradiological classification system.

Methods: The medical records of 32 SBO patients that were treated at a tertiary care center between 2006 and 2017 were retrospectively reviewed. Read More

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October 2021

[Analysis on endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach under the microscope for skull base tumor with intra and extra-cranial involvement].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Jan;56(1):33-40

Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital, Tianjin 300350, China.

To evaluate the application of combination use of endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically in skull base tumor with intra and extra-cranial involvement. A total of 7 patients (4 males and 3 females, aging from 27 to 65 years old, with a medium age of 48) undergone complicated skull base surgeries via endoscopic endonasal approach combined with the frontotemporal orbitozygomatic approach microscopically from May 2016 to January 2018 were reviewed respectively. The patients included 2 cases of recurrent invasive pituitary adenoma, 3 cases of basal skull meningiomas, 1 case of clivus chondrosarcoma, and 1 case of recurrent nasopharyngeal carcinoma. Read More

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January 2021

Morphometric Study of the Posterior Fossa: Identification of Practical Parameters for Tailored Selection of Surgical Routes to the Petroclival Region.

J Neurol Surg B Skull Base 2022 Feb 10;83(1):37-43. Epub 2020 Sep 10.

Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, Kentucky, United States.

 The petroclival region is an integral part of the skull base. It can harbor different pathologies and provides access to the petroclival junction and cerebellopontine angle. We present the results of the morphometric analysis of the posterior fossa and a prediction model to enable skull base surgeons to choose an optimal surgical corridor considering patient's bony anatomy. Read More

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February 2022

Transmastoid and Transtemporal Drainage of Petrous Apicitis with Otitis Media.

Ann Otol Rhinol Laryngol 2021 Mar 8;130(3):314-318. Epub 2020 Aug 8.

Department of Otolaryngology-Head and Neck Surgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

Background: Petrous apicitis (PA) is a serious infection involving the apical portion of the petrous temporal bone. The classic triad of purulent otorrhea, ipsilateral abducens nerve palsy and retroorbital pain is rarely seen due to early detection and widespread use of antibiotics. Medical management is the primary treatment modality with surgery reserved for cases of recalcitrant petrous apex abscess. Read More

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Prediction of skull base osteomyelitis in necrotising otitis externa with diffusion-weighted imaging.

J Laryngol Otol 2020 May 5;134(5):404-408. Epub 2020 Jun 5.

Department of Diagnostic Radiology, Mansoura University Faculty of Medicine, Mansoura, Egypt.

Objective: To predict skull base osteomyelitis in patients with necrotising otitis externa using diffusion-weighted imaging.

Methods: A retrospective analysis was conducted of 25 necrotising otitis externa patients with skull base osteomyelitis (n = 10) or without skull base involvement (n = 14) who underwent a single-shot diffusion-weighted imaging of the skull base.

Results: The respective mean apparent diffusion coefficient values of the skull base, as determined by two reviewers, were 0. Read More

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Hybrid antero-lateral transcondylar approach to the clivus: a laboratory investigation and case illustration.

Acta Neurochir (Wien) 2020 06 25;162(6):1259-1268. Epub 2020 Apr 25.

Department of Neurosurgery, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université de Paris, 2 rue Ambroise Pare, 75010, Paris, France.

Background: Surgical treatment of lesions involving the ventral craniovertebral junction (CVJ) and the lower clivus, traditionally involved complex lateral or transoral approaches to the skull base. However, mid or upper clivus involvement requires more extensive lateral approaches. Recently, the endoscopic endonasal approach (EEA) has become the standard for upper CVJ lesions and medial clival, and a valuable alternative for those tumors extending in its upper third as well as laterally. Read More

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Skull Base Osteomyelitis Complicated by Petrous Internal Carotid Artery Blowout.

Ear Nose Throat J 2021 Sep 5;100(5_suppl):790S-794S. Epub 2020 Mar 5.

Division of Otolaryngology, Brigham and Women's Hospital, 1811Harvard Medical School, Boston, MA, USA.

Skull base osteomyelitis (SBO) is an invasive infection of the external auditory canal, with involvement of the skull base, typically in the elderly diabetic population. Diagnosis may be challenging, as it requires a combination of clinical, laboratory, and radiographical findings. The mainstay of treatment is long-term antibiotic therapy, but surgical debridement of the temporal bone may be necessary in refractory cases. Read More

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September 2021

Severe Daily Headache as an Uncommon Manifestation of Widespread Skull Base Osteomyelitis.

Case Rep Neurol 2019 May-Aug;11(2):178-182. Epub 2019 May 21.

Department of Neurology, Leiden University Medical Centre/Haga Hospital, Leiden, The Netherlands.

Temporal bone osteomyelitis has been recognized for decades as a complication of otitis externa, specifically in elderly patients with diabetes. A much less prevalent form is skull base osteomyelitis. We report a 70-year-old man with diabetes who presented to our outpatient clinic with severe chronic daily complaints of headache. Read More

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Insidious onset of headache, diplopia and Horner's syndrome: a rare case of petrous bone osteomyelitis.

BMJ Case Rep 2019 Sep 18;12(9). Epub 2019 Sep 18.

Diabetes and Endocrine, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.

We present an unusual case of skull base osteomyelitis in an 88-year-old woman. She presented with gradual onset unilateral headache and diplopia. On examination, there was evidence of a left-sided Horner's and ipsilateral sixth nerve palsy. Read More

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September 2019

CT and clinical prognostic factors in Bell's palsy: A study of 56 cases.

Clin Otolaryngol 2019 09 7;44(5):861-864. Epub 2019 Jul 7.

ENT Department, Pitié-Salpêtrière University Hospital, Paris Greater University Hospitals, Paris, France.

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September 2019

Extensive Skull Base Osteomyelitis Secondary to Malignant Otitis Externa.

J Int Adv Otol 2019 Dec;15(3):463-465

Infectious Disease Unit, University Hospital of Pisa, Pisa, Italy.

Skull base osteomyelitis is a severe complication of malignant otitis externa that affects the marrow of the temporal, sphenoid, and occipital bones. Skull base osteomyelitis is usually diagnosed based on clinical, microbiological, and radiological findings. Here, we present the imaging findings of a 76-year-old man who initially presented with right-sided malignant otitis externa, with the involvement of the otomastoid structures and ipsilateral temporal bone. Read More

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December 2019

Cochlear Implantation in Chronic Otitis Media With Cholesteatoma and Open Cavities: Long-term Surgical Outcomes.

Otol Neurotol 2018 01;39(1):45-53

Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Rome, Italy.

Objectives: To evaluate the long-term surgical outcomes of cochlear implantation (CI) in chronic otitis media (COM) with cholesteatoma and open cavities using subtotal petrosectomy (STP). To review device explantation (DE) patients and reimplantation considerations.

Study Design: Retrospective review. Read More

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January 2018

Pediatric Langerhans cell histiocytosis of the lateral skull base.

Int J Pediatr Otorhinolaryngol 2017 Aug 15;99:135-140. Epub 2017 Jun 15.

Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address:

Objective: Describe the presentation, imaging characteristics, management, and outcomes of pediatric patients with Langerhans cell histiocytosis (LCH) of the temporal bone.

Methods: A retrospective chart review was performed between 2000 and 2014 at a single tertiary care children's hospital. Fourteen patients were identified with a diagnosis of LCH and involvement of the temporal bone. Read More

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Severe skull base osteomyelitis caused by Pseudomonas aeruginosa with successful outcome after prolonged outpatient therapy with continuous infusion of ceftazidime and oral ciprofloxacin: a case report.

J Med Case Rep 2017 Feb 21;11(1):48. Epub 2017 Feb 21.

Infectious Diseases Unit, Hospital General Universitario de Elche, Camino de la Almazara, 11, 03203, Elche, Alicante, Spain.

Background: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Read More

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February 2017

A case of generalized lymphatic anomaly causing skull-base leakage and bacterial meningitis.

Brain Dev 2017 May 13;39(5):444-447. Epub 2017 Jan 13.

Department of Pediatrics and Tokushima Prefectural Central Hospital, Japan.

Generalized lymphatic anomaly is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 3year-old Japanese boy presented with right facial palsy due to cystic tumors in the ipsilateral petrous bone. Pericardial effusion had been found incidentally and generalized lymphatic anomaly had been diagnosed by pericardial biopsy. Read More

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[Apical petrositis, osteomyelitis of the base of the skull bones and of the first cervical vertebra in a 5 year-old children following chicken pox].

Vestn Otorinolaringol 2016 ;81(1):61-63

Pirogov Russian National Research Medical University, Moscow, Russia, 117997.

This publication was designed to describe a rare case of development of apicalpetrositis in a child presenting with acute otitis mediafollowing chicken pox experienced in the preceding period. We carried out the study with the use of computed tomography (CT) that demonstrated destruction of the temporal bone, bones of the base of the skull and of the first cervical vertebra. The treatment strategy chosen for the management of this condition that included antibiotic therapy and expectant observation proved justified and can be recommended as an algorithm of choice taking into consideration the difficulty of surgical approach to the apex of the petrous pyramid. Read More

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Gruber, Gradenigo, Dorello, and Vail: key personalities in the historical evolution and modern-day understanding of Dorello's canal.

J Neurosurg 2016 Jan 26;124(1):224-33. Epub 2015 Jun 26.

Departments of 1 Neurological Surgery and.

A century ago an ambitious young anatomist in Rome, Primo Dorello, who sought to understand the cause of abducent nerve palsy that often occurred in patients with severe middle ear infections, conducted intricate studies on the intracranial course of the nerve. In his findings, he identified that the abducent nerve passes through a narrow sinus near the apex of the petrous bone, which formed an osteofibrous canal. Dorello suggested that in this enclosed region the abducent nerve may be particularly vulnerable to compression due to the vascular edema accompanying the infection. Read More

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January 2016

Gradenigo's syndrome as first presentation of solitary osseous plasmacytoma of the petrous apex.

Arch Iran Med 2014 Jul;17(7):526-8

Department of Neurosurgery, Arad Hospital, Tehran, Iran.

Plasma cell tumors of the skull base are rare in neurosurgical practice. True solitary osseous plasmacytoma of the skull base without development of multiple myeloma is extremely rare. We report a case of typical Gradenigo's syndrome, including left abducens nerve palsy, left facial pain and paresthesia in V1 and V2 distribution of trigeminal nerve caused by solitary osseous plasmacytoma of the left petrous apex. Read More

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Skull base osteomyelitis in otitis externa: The utility of triphasic and single photon emission computed tomography/computed tomography bone scintigraphy.

Indian J Nucl Med 2013 Apr;28(2):65-9

Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Skull base osteomyelitis (SBO) refers to infection that has spread beyond the external auditory canal to the base of the skull in advanced stages of otitis externa. Clinically, it may be difficult to differentiate SBO from severe otitis externa without bony involvement. This study was performed to determine the role of three phase bone scintigraphy (TPBS) and single photon emission tomography/computed tomography (SPECT/CT) in detecting SBO. Read More

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The role of subtotal petrosectomy in cochlear implant surgery--a report of 32 cases and review on indications.

Otol Neurotol 2013 Aug;34(6):1033-40

Department of Otorhinolaryngology-Head and Neck Surgery, Cochlear Implant Center Northern Netherlands, University Medical Center Groningen, University of Groningen, The Netherlands.

Objective: To report and review 32 cases of subtotal petrosectomy (SP) in cochlear implant (CI) surgery and to define the indications and contraindications for this procedure.

Study Design: Retrospective case review + case reports.

Setting: Tertiary skull base center. Read More

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Aspergillus petrous apicitis associated with cerebral and peritubular abscesses in an immunocompetent man.

J Laryngol Otol 2013 Apr 28;127(4):404-7. Epub 2013 Feb 28.

Department of Otolaryngology Head and Neck Surgery, Royal Preston Hospital, UK.

Background: Petrous apex aspergillosis is an uncommon and dangerous condition, with only four previously reported cases. As with other forms of petrous apicitis, the clinical symptoms are often non-specific and this contributes to diagnostic delay. This paper presents the first reported case of Aspergillus petrous apicitis associated with an intracranial or nasopharyngeal abscess. Read More

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Dural angioleiomyoma of the middle cranial fossa: a case report and review of the literature.

Brain Tumor Pathol 2013 Apr 17;30(2):117-21. Epub 2012 Aug 17.

Department of Pathology, Wuxi People's Hospital Affiliated to Nanjing Medical University, 299 Qingyang Road, Wuxi, 214023, Jiangsu, People's Republic of China.

We describe a case of dural angioleiomyoma (ALM) of the middle cranial fossa. A 62-year-old man was referred to our center for fracture of the left clavicle because of a fall, and he had a sudden seizure during admission. The mass was completely resected. Read More

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Pipeline embolization device and subsequent vessel sacrifice for treatment of a bleeding carotid pseudoaneurysm at the skull base: a case report.

J Neurointerv Surg 2013 Sep 28;5(5):e31. Epub 2012 Jul 28.

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.

An attempt at parent vessel reconstruction with Pipeline embolization devices to treat a mycotic pseudoaneurysm of the internal carotid artery at the skull base is presented. A 50-year-old woman with malignant otitis externa and bilateral temporal bone osteomyelitis presented with brisk bleeding from her left ear. She had bony dehiscence of the left carotid canal at CT and extravasation from a pseudoaneurysm of the carotid petrous segment at angiography. Read More

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September 2013

Repair of cerebrospinal fluid leak via petrous bone using multilayer technique with hydroxyapatite paste.

World Neurosurg 2010 Dec;74(6):650-3

Department of Neurosurgery, The University of Tokyo, Tokyo, Japan.

Objective: Repairing bone defects after drilling in skull base surgery is difficult in deeper locations, the posterior wall of the internal auditory canal, and the petrous apex. These defects traditionally have been repaired by soft tissue, such as fascia, muscle, or adipose tissue, coupled with lumbar drainage for several days postoperatively.

Methods: To repair cerebrospinal fluid (CSF) leakage through air cells in the petrous bone, we applied a multilayer technique using hydroxyapatite cement (HAC) in three patients with postoperative CSF leakage. Read More

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December 2010

Isolated sphenoid sinus disease: differential diagnosis and management.

Curr Opin Otolaryngol Head Neck Surg 2011 Feb;19(1):16-20

Department of Otolaryngology, Singapore General Hospital, Singapore.

Purpose Of Review: To review the current literature on isolated disease of sphenoid sinus, and to describe the various approaches to the sphenoid sinus.

Recent Findings: Due to its posterior location and subtle presenting symptoms, sphenoid lesions, in the past, have often been missed and were reported as rare occurrences. However, with the availability of current diagnostic modalities such as endoscopy and imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), diseases of the sphenoid sinus are now more frequently diagnosed. Read More

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February 2011

A successful combined endovascular and surgical treatment of a cranial base mucormycosis with an associated internal carotid artery pseudoaneurysm.

Neurosurgery 2009 Oct;65(4):733-40; discussion 740

Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA.

Objective: We report a rare case of internal carotid artery pseudoaneurysm owing to rhinocerebral mucormycosis and review 40 reported cases from 1980 to present.

Clinical Presentation: A 38-year-old Caucasian man presented with a 3-day history of headache, diplopia, and numbness in the distribution of the left ophthalmic and maxillary branches of the trigeminal nerve. A complete left cavernous syndrome was discovered upon neurological examination. Read More

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October 2009

Gradenigo syndrome without acute otitis media.

Pediatr Neurol 2009 Sep;41(3):215-9

Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, University of Bordeaux, Bordeaux F-33000, France.

Acute otitis media complications are less and less common, thanks to the more widespread availability and use of adequate antibiotics. Nevertheless, when they occur, they may be inconspicuous or silent but with dangerous evolution. Described here is the case of a 5-year-old child suffering from incomplete Gradenigo syndrome without acute otitis media, which was managed medically with favorable outcome. Read More

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September 2009

Otogenic cranial base osteomyelitis: a proposed prognosis-based system for disease classification.

Otol Neurotol 2008 Aug;29(5):666-72

Department of Otolaryngology, The Alfred Hospital, Prahran, Victoria, Australia.

Objectives: To review the presentation, microbiology, and long-term results of treating otogenic cranial base osteomyelitis to develop a prognosis-based disease classification system.

Patients And Methods: Thirty-eight patients with otogenic cranial base osteomyelitis treated between 1989 and 2002 were studied. Patient demographics, presentation, pathogens, details of therapy, and disease-specific survival were recorded. Read More

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