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. 2014:2014:591714.
doi: 10.1155/2014/591714. Epub 2014 May 18.

Temporal bone osteomyelitis: the relationship with malignant otitis externa, the diagnostic dilemma, and changing trends

Jia-Cheng Chen  1 , Chien-Fu Yeh  2 , An-Suey Shiao  2 , Tzong-Yang Tu  2
Affiliations

Temporal bone osteomyelitis: the relationship with malignant otitis externa, the diagnostic dilemma, and changing trends

Jia-Cheng Chen et al. ScientificWorldJournal. 2014.

Abstract

Fifty-five patients hospitalized for osteomyelitis of the temporal bone between 1990 and 2011 were divided into two study groups: group 1 was patients collected from 1990 to 2001 and group 2 was composed of patients between 2002 and 2011. Clinical diagnostic criteria and epidemiologic data were analyzed to illustrate the altering features of osteomyelitis of the temporal bone. Group 1 patients were characterized by high prevalence of diabetes and more commonly suffered from otalgia, otitis externa and granulation tissue in the external auditory canal and higher positive culture for Pseudomonas aeruginosa. Noticeable changing trends were found between both groups, including declining prevalence of diabetes, fewer patients complaining of pain or presenting with otitis externa, and canal granulation, and increased variety of pathogens in group 2. We should highlight the index of clinical suspicion for osteomyelitis of the temporal bone, even in nondiabetic or immunocompetent patients. Painless otorrhea patients were also at risk of osteomyelitis of the temporal bone, especially patients with previous otologic operation. Increased multiplicity of pathogens amplified the difficulty of diagnosis for osteomyelitis of the temporal bone.

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Figures

Figure 1
Figure 1
Images of a patient of temporal bone osteomyelitis after radiotherapy for nasopharyngeal carcinoma. (a) CT. (b) Contrast-enhanced T1-weighted MR. (c) Tc99m bone scan. (d) Gallium scan. See text for details.
Figure 2
Figure 2
Images of a patient of temporal bone osteomyelitis without history of DM. (a) CT. (b) Contrast-enhanced T1-weighted MR. (c) Tc99m bone scan. (d) Gallium scan. See text for details.
Figure 3
Figure 3
Images of a patient of temporal bone osteomyelitis after surgery for chronic otitis media with cholesteatoma. (a) CT. (b, c) Tc99m bone scan. (d) Gallium scan. See text for details.
Figure 4
Figure 4
Images of a patient of temporal bone osteomyelitis caused by nontuberculous mycobacteril infection. (a) CT. (b) Contrast-enhanced T1-weighted MR. (c) Tc99m bone scan. (d) Gallium scan. See text for details.
See this image and copyright information in PMC

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