Diagnosis and therapy of osteomyelitis of the temporal bone

Introduction Osteomyelitis of the temporal bone (Otitis externa maligna) is a rare and often threatening disease.

Methods Over the past 10 years, a total of 21 cases of osteomyelitis of the temporal bone have been diagnosed and treated. The cases were evaluated retrospectively with regard to microbiological and radiological findings, clinical appearance and therapeutic management.

Results The predominant symptoms at diagnosis were hearing loss, otorrhoea and severe otalgia. Pareses of the cranial nerves VI, VII, IX and XII as well as paresis of the recurrens nerve were occasionally present. Pseudomonas aeruginosa was most frequently (n=13, 61.9 %) detected in the preoperative and intraoperative swabs. Radiological imaging frequently showed bone destructions. Frequent comorbidities were diabetes mellitus (n=10, 47.6 %) and arterial hypertension (n=8, 38.1 %). The vast majority of patients (n=20, 95.2 %) underwent surgery. In all cases an antibiotic therapy was performed. In the follow-up after the end of therapy 8 patients (38.1 %) were in good general condition and 9 patients (42.9 %) in reduced general condition. 4 of the 21 patients died.

Conclusion There is no uniform treatment concept for osteomyelitis of the temporal bone. The therapeutic procedure depends on the findings and course and must be adapted individually. Radical surgical treatment is of central importance in addition to antibiotic therapy.

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Publication History

Article published online:
10 June 2020