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Case Reports in Otolaryngology
Volume 2017 (2017), Article ID 4097973, 8 pages
https://doi.org/10.1155/2017/4097973
Case Report

Clinical Challenges in the Diagnosis and Treatment of Temporal Bone Osteomyelitis

1Faculty of Medicine, Vilnius University, Ciurlionio 21/27, LT-03101 Vilnius, Lithuania
2Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Siltnamiu 29, LT-04130 Vilnius, Lithuania
3Department of Ear, Nose and Throat Diseases, Republican Vilnius University Hospital, Siltnamiu 29, LT-04130 Vilnius, Lithuania

Correspondence should be addressed to Irina Arechvo; moc.liamg@ovhcera

Received 26 December 2016; Revised 21 February 2017; Accepted 26 March 2017; Published 9 April 2017

Academic Editor: Holger Sudhoff

Copyright © 2017 Liubov Kornilenko et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Temporal bone osteomyelitis is a serious life-threatening condition—a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality. Changing trends of the disease make a differential diagnosis difficult. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. Neoplasm and granulomatous inflammation were excluded by multiple biopsies. The disease can develop in nondiabetic patients. The disorder might be related to the initial inflammatory process in the middle ear with further direct spreading of infection through defects in the bony walls to deep temporal bone structures. Imaging should be performed early to detect osteolytic lesions of the skull base. Surgery was used for the presence of bone sequestra and infratemporal abscess.