Skull Base Osteomyelitis (Malignant Otitis Externa): A Comprehensive Review of Pathophysiology, Diagnosis, and Management
Background: Skull base osteomyelitis (SBO), often referred to as malignant otitis externa (MOE), is a rare but severe infection primarily affecting immunocompromised individuals. This condition can lead to significant morbidity due to its aggressive nature and potential complications, including cranial nerve palsies and intracranial spread.Objective: The objective of this review is to provide an in-depth analysis of the pathophysiology, clinical presentation, diagnostic challenges, and management strategies for SBO/MOE, incorporating the latest advances in the field.Methods: A comprehensive literature review was conducted using databases like PubMed, MEDLINE, and Scopus, focusing on studies and case reports published over the last 25 years.Results: SBO/MOE is predominantly caused by Pseudomonas aeruginosa and is characterized by severe otalgia, otorrhea, and progressive cranial nerve deficits. Early diagnosis and aggressive treatment are crucial for improving outcomes. Conclusion: Despite advancements in imaging and microbiological techniques, SBO/MOE remains a challenging condition to manage. Continued research is essential to develop more effective therapies and diagnostic tools.