Ostéomyélite de l’étage moyen de la base du crâne d’origine sinusienne

Abstract

The study goals were to determine the patient demographics, identify predisposing factors, and determine efficacy of treatment for nonotologic osteomyelitis of the middle skull base. Symptoms and treatment of five patients (sex ratio: 3/1; mean age: 57,1 ans) with osteomyelitis of the middle skull base treated from 1991 to 2005 are analyzed. All patients with a biopsy-proven diagnosis of osteomyelitis of the skull base were retrospectively evaluated. Four patients presented with asthenia, weight loss, headache, and fever. No patient presented with neurologic deficits associated with a destructive lesion of the osseous skull base. Three patients had an underlying immunocompromising condition (diabetes mellitus, steroid and immunosuppressor use). CT scan and MRI demonstrated central skull base abnormality, mainly at the level of the clivus. Systemic antibacterial/antifungal therapy, aggressive debridement of involved bone, and medical optimization remain important in the treatment of this group of patients. The interpretation of the results is performed after an analysis of the literature.