Skull base osteomyelitis in patients with head and neck cancer: Diagnosis, management, and outcomes in a case series of 23 patients

Laryngoscope Investigative Otolaryngology

Nancy Fischbein¹  Peter H. Hwang¹  Alexander Dimitrios Colevas¹  Mary M. Czech²  Dora Y. Ho² 

[1]Department of Otolaryngology—Head and Neck Surgery Stanford University School of Medicine Stanford California USA

[2]Division of Infectious Diseases and Geographic Medicine, Department of Medicine Stanford University School of Medicine Stanford California USA

关键词: head and neck cancer;    nasopharyngeal carcinoma;    osteoradionecrosis;    skull base osteomyelitis;   

DOI  :  10.1002/lio2.719

来源: DOAJ

【 摘 要 】

Abstract Background Skull base osteomyelitis (SBO) is an infection of the central cranial bones, most commonly resulting from contiguous spread of infection from adjacent head and neck structures. SBO is a well‐recognized complication of treatment of head and neck cancer (HNC) that results in significant morbidity. Methods We conducted a retrospective chart review of HNC patients diagnosed with SBO. Results SBO was commonly diagnosed with nasal endoscopy showing mucosal breakdown between the naso/oropharynx and skull base and with characteristic changes on CT/MRI. Culture data were often polymicrobial, inclusive of naso/oropharyngeal flora, but half of the patients additionally had antibiotic‐resistant or atypical pathogens. The mean duration of antimicrobial therapy was 117 +/− 94 days. Recurrent SBO was found in half of the patients, associated with Pseudomonas aeruginosa and with persistent defects in the mucosa abutting the skull base. Conclusions Diagnosis and management of SBO in HNC patients are challenging. Recommendations to aid in clinical care are proposed. Level of evidence 4, case series.

【 授权许可】

Unknown