Osteomyelitis 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 cause pronounced functional limitations. The causative agents are usually S. aureus, enterococci and mixed infections with anaerobes and fungi. A 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 In the period 2014-2019, 14 patients (7 women and 7 male) were treated with a temporal bone osteomyelitis at University Medical Center. The age was between 11-89 years. The mean age was 64 years.

Result 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. It was mainly P. aeruginosa, S. aureus and Candida can be isolated as a pathogen. All patients underwent surgical treatment with antibiosis. In 40 %  a intensive care was necessary. Regrettably, two patients died regardless of the initiation of maximal therapy.

Conclusion The osteomyelitis of the temporal bone is a rare and serious disease that can lead to life-threatening functional limitations and life-threatening complications without adequate treatment. Therefore, the successful treatment of early pathogen identification and initiation of a targeted antibiotic with subsequent surgical rehabilitation of greatest importance.

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Publication History

Article published online:
13 May 2021