Skull Base Osteomyelitis

Skull base osteomyelitis is a rare but very serious, potentially life-threatening infection. These infections generally start as an ear or sinus infection that spreads through the surrounding bone and soft tissues. Skull base osteomyelitis most commonly occurs in older patients with diabetes, although in rare cases healthy individuals can develop skull base osteomyelitis.

Symptoms and Diagnosis

You'll typically have headaches or ear pain with skull base osteomyelitis. You may also experience hearing loss, ringing in the ear, dizziness, facial weakness, double vision, hoarseness, or difficulty swallowing. On exam, there may be evidence of an ear infection with a draining ear or a sinus infection.

The initial evaluation will include multiple imaging and lab studies. You will most likely undergo both a CT scan and an MRI to diagnose skull base osteomyelitis and determine the extent of the infection. Your physician will also do lab work to look for evidence of infection.

Treatment Options

Once skull base osteomyelitis has been diagnosed, you generally will be treated with a long course of intravenous antibiotics for about six weeks. Multiple bacteria have been found to cause this condition and culture-directed therapy is essential.

In some cases, hyperbaric oxygen treatment may be used to help with the healing process. In rare cases, you might require surgical treatment of the infection. However, if surgery is required, a skilled skull base surgery team should be available.

Thanks to the effectiveness of antibiotic therapy, most patients do well despite having a potentially life-threatening infection. Occasionally, patients will need rehabilitation including rehabilitation for hearing loss, balance, and swallowing. 

The skull base surgeons at UT Southwestern Medical Center are highly experienced and widely respected for their expertise in treating illnesses such as skull base osteomyelitis. In addition, our vast research into skull base and neurological conditions allows us to apply the latest, most innovative techniques and therapies to your condition.