caa a22 4500 606186514 CHVBK 20210128100836.0 cr unu---uuuuu 210128e20150501xx s 000 0 eng 10.1007/s00405-014-3390-y doi (NATIONALLICENCE)springer-10.1007/s00405-014-3390-y Central skull base osteomyelitis: new insights and implications for diagnosis and treatment [Elektronische Daten] [Gerd Ridder, Christine Breunig, Jan Kaminsky, Jens Pfeiffer] Central skull base osteomyelitis (SBO) is a life-threatening disease originating from ear and from sinonasal infections. The intention of this study was to evaluate contemporary trends in etiology, diagnosis, management, and outcome of SBO and to draw the clinician's attention on this probably underestimated disease. Over a 6-year period we performed this systematic study in an academic quaternary medical care and skull base center including 20 patients (mean age 63.7years) with central SBO, which is one of the largest series from a single center. In contrast to previous studies we explicitly excluded infections limited to malignant external otitis only but did not restrict central SBO to conditions unrelated to aural pathology. Fifteen patients had otogenic and five sinugenic SBO; four patients had fungal or mixed fungal infections. Pre-existing illnesses altering bone vascularization were detected in 70% of the patients and had a negative effect on the improvement of cranial nerve palsies that were found in 14 patients. In relation, patients with otogenic SBO more often had local and systemic predisposing factors. Contrary to previous studies 16 patients (80%) underwent surgical therapy and none of our patients died. A meta-analysis of five recent studies was done and compared with our own data and two previous meta-analyses. The present study highlights several important aspects with major implications for diagnosis and treatment of SBO that have not been adequately addressed as yet. In contrast to the restrictive attitude towards surgery in literature we recommend early and radical operative treatment to reduce its mortality. Springer-Verlag Berlin Heidelberg, 2014 Skull base nationallicence Osteomyelitis nationallicence Malignant external otitis nationallicence Skull base osteomyelitis nationallicence Treatment outcome nationallicence Cranial nerve diseases nationallicence Ridder Gerd Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut Breunig Christine Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut Kaminsky Jan Department of Neurosurgery, University of Freiburg, Freiburg, Germany aut Pfeiffer Jens Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/5(2015-05-01), 1269-1276 0937-4477 272:5<1269 2015 272 405 https://doi.org/10.1007/s00405-014-3390-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3390-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ridder Gerd Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut NATIONALLICENCE 700 1- Breunig Christine Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut NATIONALLICENCE 700 1- Kaminsky Jan Department of Neurosurgery, University of Freiburg, Freiburg, Germany aut NATIONALLICENCE 700 1- Pfeiffer Jens Department of Otorhinolaryngology-Head and Neck Surgery, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/5(2015-05-01), 1269-1276 0937-4477 272:5<1269 2015 272 405