Osteomelitis of the temporal bone - An interdisciplinary challenge

Osteomyelitis is an inflammatory process of bone marrow, cancellous bone, compacta and periosteum. The inflammatory event can spread unimpeded to surrounding soft tissue structures and can cause severe functional limitations. The causative agents are usually S. aureus, enterococci and mixed infections with anaerobes and fungi. An osteomyelitis of the temporal bone can develop as a rare complication of inflammatory ear diseases. The clinical appearance ranges from local symptoms to life-threatening systemic complications.

Method During the period 2014-2019, 14 patients (7 women and 7 male) were treated with a temporal bone osteomyelitis at the Charité, University Medical Center Berlin. The age ranged between 11-89 years. All patients had an inflammatory disease in the auditory canal or middle ear. The symptoms varied from otalgia with hearing loss to complex failures of the caudal cranial nerves and meningitis. Predominantly P. aeruginosa, S. aureus and Candida could be isolated as a pathogen. All patients underwent surgical treatment with antibiosis. In 5 patients intensive care was necessary. Regrettably, two patients died regardless of the initiation of maximum therapy.

Conclusion The osteomyelitis of the temporal bone is a rare and serious disease that can, without adequate treatment, lead to life-threatening functional limitations and life-threatening complications. Therefore, for successful treatment, early pathogen identification, initiation of antibiosis and subsequent surgery is of great importance.

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Artikel online veröffentlicht:
10. Juni 2020