A case of atypical skull base osteomyelitis with few signs of inflammation in the middle or outer ear

Abstract

We report a case of atypical skull base osteomyelitis with few signs of inflammation in the middle or outer ear. A 73-year-old man with a history of diabetes visited our hospital complaining of right earache and headache. A decreased bone marrow signal was observed on T1-weighted MRI, and skull base osteomyelitis was suspected. It is thought that the inflammation of the temporal bone was partially resolved due to inadequate treatment of the malignant external otitis; however, the inflammation that remained in the deep part of the skull base led to the development of skull base osteomyelitis. MRI evaluation is important in cases of skull base osteomyelitis without intra-aural findings, as in the present case. Fortunately, the patient responded well to antimicrobial treatment.