Clinical Challenges in the Diagnosis and Treatment of Temporal Bone Osteomyelitis

Figure 6

(a) The 3D volume rendering technique shows the lateral surface of the temporal bone: the destruction of the base of the styloid process (vaginal process) is clearly seen. Anterior dislocation of the mandible with subluxation of the condyle is shown with arrows. Note slight cortical erosion of the mastoid process of the right side. (b) Inferior view of the skull base: massive destruction of the petrous and tympanic parts of the temporal bone is marked with arrows. (c) The most severe bone lytic changes were observed around the carotid foramen (arrows). (d) A destruction of the carotid plate is clearly seen on this coronal reformat (arrow). (e) The other possible infection-spreading pathway was from the external auditory canal. Asterisk shows a defect in the anterior wall of the latter. Additionally, arrows show erosion of the mandibular fossa roof as well as auricular tubercle. Note an anterior dislocation of the mandibular condyle. (f) Axial CT scan shows the destruction of the cortical layer of the occipital bone (arrows).

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