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Case Reports
. 2022 Sep 25;14(9):e29548.
doi: 10.7759/cureus.29548. eCollection 2022 Sep.

Transoral Biopsy of the Clivus in a Pediatric Patient for Suspected Osteomyelitis

Ethan Davoudzadeh  1 , Kan Chen  1 , Faizullah Mashriqi  1 , Drew M Caplin  1
Affiliations
Case Reports

Transoral Biopsy of the Clivus in a Pediatric Patient for Suspected Osteomyelitis

Ethan Davoudzadeh et al. Cureus. .

Abstract

Pediatric skull base osteomyelitis is an uncommon and difficult infection to characterize and treat, and it can result in devastating neurologic sequela. While transoral biopsy of the clivus in the adult population has been demonstrated, no such case is reported in the literature for the pediatric population for the purposes of elucidating an infectious source. Here we describe transoral biopsy of the clivus utilizing computed tomography (CT) guidance in a pediatric patient with suspected skull base osteomyelitis.

Keywords: clivus; grisel syndrome; interventional radiology; osteomyelitis; skull base; transoral biopsy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Grisel syndrome
(A) Sagittal section contrast-enhanced CT of the neck; (B) Sagittal section T2-weighted image with fat suppression of the cervical spine; (C) Axial section T2-weighted image with fat suppression of the skull base; (D) Axial section T1-weighted image pre-contrast of the skull base; (D) Axial section T1-weighted image post-contrast of the skull base.
Figure 2
Figure 2. Skull base osteomyelitis
(A) Sagittal section T2-weighted image with fat supression of the cervical spine; (B) Sagittal section T1-weighted image pre-contrast of the cervical spine; (C) Sagittal section T1-weighted image post-contrast of the cervical spine.
Figure 3
Figure 3. Transoral biopsy of the clivus
(A) Axial intraoperative CT at the level of the foramen magnum; (B) Sagittal intraoperative CT at the midline; (C) Intraoperative 3D reconstruction.
See this image and copyright information in PMC

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