Osteomyelitis of the skull base: the role of high resolution CT in diagnosis

Abstract

Osteomyelitis of the skull base (involving the temporal, occipital or sphenoid bones) is an uncommon condition occurring in elderly diabetic patients which was almost always fatal in the pre-antibiotic era. Despite the advent of effective antibiotics against the usual causative organism, Pseudomonas aeruginosa, the mortality remains high and is related to delay in diagnosis and inappropriate treatment. We report three cases of osteomyelitis of the skull base, in order to illustrate the difficulties encountered in diagnosis and management. The CT scan appearances, which would appear to be typical for the disease, are described and the pathogenesis of skull base osteomyelitis is discussed.