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Cranial Osteomyelitis: A Comprehensive Review of Modern Therapies
- Source :
- World Neurosurgery. 111:142-153
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background Cranial osteomyelitis is a rare but potentially life-threatening condition that requires early diagnosis with prompt and appropriate management by neurosurgeons to prevent further central nervous system complications. Methods The literature in the Medline database was comprehensively reviewed with the keywords “cranial osteomyelitis,” “skull base osteomyelitis (SBO),” “central skull base osteomyelitis,” and “temporal bone osteomyelitis.” Items in the reference list of each article relevant to the objective of this study were reviewed. Results This review produced 183 articles: 13 book chapters, 24 case reports, 17 case series, 98 original articles, 30 review articles, and 1 meta-analysis. We classified cranial osteomyelitis as sinorhino-otogenic, including anterior, middle, and posterior skull base osteomyelitis; and non-sinorhino-otogenic, including iatrogenic, posttraumatic, hematologic, and osteomyelitis with other causes. Conclusions New diagnostic modalities, the introduction of broad-spectrum antibiotics, and recent advances in neurosurgical procedures have led to a decrease in the rate of treatment failure in cranial osteomyelitis. Early recognition of initial nonspecific symptoms is key to diagnosing and managing this treatable but life-threatening condition. Early identification of the causative pathogen, appropriate broad-spectrum antibiotic therapy over a period of 8–20 weeks, and aggressive surgical debridement are essential for managing cranial osteomyelitis. On the other hand, inadequate treatment is responsible for refractory cases and poses a great diagnostic challenge. A new classification dividing cranial osteomyelitis into sinorhino-otogenic versus nonsinorhino-otogenic groups could prove valuable for clinical communication and treatment.
- Subjects :
- Skull Base
medicine.medical_specialty
business.industry
Osteomyelitis
Skull
Surgical debridement
Skull base osteomyelitis
medicine.disease
Surgery
Diagnostic modalities
Clinical communication
03 medical and health sciences
0302 clinical medicine
Posterior skull base
Temporal bone
Humans
Medicine
Treatment Failure
Neurology (clinical)
030223 otorhinolaryngology
business
Medline database
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 111
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....084ecadb9dd500fd33366ba139aa3e73