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J Laryngol Otol. 2002 Jul;116(7):556-8.

Masked pseudomonal skull base osteomyelitis presenting with a bilateral Xth cranial nerve palsy.

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Department of Otolaryngology, St George's Hospital, London, UK.


Skull base osteomyelitis classically presents as a complication of severe external otitis, middle ear, mastoid or sinus infection and can lead to multiple lower cranial nerve palsies when the jugular foramen is involved as a consequence of widespread involvement of the skull base. Bilateral skull base osteomyelitis is a recognized phenomenon, but has not previously been reported secondary to pseudomonal infection in the absence of a clinically obvious focus of infection. We report the case of a 77-year-old diabetic patient who presented with dysphonia and dysphagia and had a bilateral Xth cranial nerve palsy. No focus of infection was evident on presentation. Subsequent radiological investigation confirmed the diagnosis of bilateral skull base osteomyelitis.

[Indexed for MEDLINE]

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