Bacteria and fungal infections can cause a condition known as skull-base osteomyelitis (SBO), which can cause severe pain in the areas of the ear and the base of the skull. These infections usually originate in ear tissue and spread to the temporal bone. If SBO is left untreated, it can continue to spread throughout the skull causing serious complications such as facial paralysis.
The University of Virginia Health Systems reports that osteomyelitis is an infection of bone tissue that causes inflammation. Osteomyelitis can affect people of any age group and gender and can also affect any bone in the body. However, the condition is more prone to affecting the long bones of the body and also is most prevalent in people with weakened immune systems.
In the book, “Current Diagnosis and Treatment in Otolaryngology,” author Anil K. Lalwani explains that aside from the skull and ear pain (otalgia) that is associated with skull-based osteomyletitis is the possibility of hearing loss. This type of hearing loss is usually do to excessive amounts of swelling around the cochleovestibular nerve. Discharge may also be excreted from the ear (otorrhea) as well as a rash (pruritis).
Skull-base osteomyelitis can usually be diagnosed with an MRI (magnetic resonance imaging) or a CT scan. Sometimes a contrast agent will also be administered to help highlight the infected area of bone. According to Scott Kaszuba, M.D., of Baylor College of Medicine, there are three different stages of skull-base osteomyelitis.
The three stages of skull-base osteomyelitis that originate from infected ear tissue range in severity. Stage one is denoted by infected ear tissue that is attached to the skull; however, the skull itself is not infected. Stage two is a little more serious with the infection affecting ear tissue and the mastoid portion of the temporal bone of the skull. Stage three involves ear tissue and several different boney areas of the skull. The extent of stage three can be extreme with infected areas of the skull extending to the facial bones, occipital bone and the anterior and posterior bones of the skull.
The treatment of skull-base osteomyelitis can be intense and can involve several different physicians working together. Most often recovery will require the help of physicians in the fields of audiology, otolaryngology and otology. According to the University of Texas Medical Branch at Galveston (UTMB), the treatment for skull-base osteomyelitis will vary depending on the degree of the infection but the administration of intravenous antibiotics for a six week period may be necessary along with hyperbaric oxygen therapy.
It is important to point out that skull-base osteomyelitis can also affect the eyes. This is especially true if the infection spreads to the area of skull tissue around the eyes and other soft tissue areas.