ATYPICAL OSTEOMYELITIS OF THE SKULL BASE
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The authors reporetd six cases of atypical osteomyelitis of the skull base in diabetic patients. They were studied clinically, radiologically and pathologically. This disease may arise without intial temporal bone affection or may complicate incompletely treated malignant otitis extema. Spread of the disease may occur through vascular involvement of the skull bones and fascial planes rather than through the air cells. The ethmaid the sphenoid and occipital bones are affected beside the temporal bones and the petrous apex. Multiple cranial nerves may be affected inducing the 2nd, 3rd, 4th. 5th, 9th and 10th nerves and the disease may present as the jugular foramen. or the orbital art syndromes. The morbidity and the mortality of the disease is higher in patients wthout previous temporal bone affection because it is usually not promptly recognized and treated.