Skip to main content
SpringerLink
Log in

General Considerations and Surgical Therapy

  • Chapter
  • First Online:
Cranial Osteomyelitis

Abstract

The cornerstone of appropriate therapy for cranial osteomyelitis is precise diagnosis. Treatment of this infectious disease is not standardized due to the variable clinical presentations, locations, severities, etiologies and the lack of data from randomized controlled trials. However, it is necessary to develop a management plan and a final treatment strategy for each patient in close collaboration with otolaryngologist, microbiologist, radiologist, infectious disease specialist and plastic surgeon among others. The spectrum of treatment goes from antibiotic therapy alone to combination with simple incision and drainage to invasive surgery. However, most diagnoses are delayed needing combination of surgical debridement, correction of the primary source of infection and long term use of antimicrobial agents. Also, patients with extracranial involvement or with acute localized osteomyelitis tend to be managed more conservatively than those with intracranial extension or with chronic destructive forms. The aim of this chapter is to expose the different surgical procedures used in the treatment of cranial bone infection with or without complications and to discuss the current controversies in the management of main forms of this complex infectious illness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

CSF:

Cerebrospinal fluid

HBOT:

Hyperbaric oxygen therapy

References

  1. Fleming H. Osteomyelitis of the skull. Cal West Med. 1925;23(8):985–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Phillips K. Osteomyelitis of the skull. J Neurosurg Nurs. 1982;14(5):280–2.

    Article  CAS  PubMed  Google Scholar 

  3. Boeckx WD, van der Hulst RR, Nanhekhan LV, De Lorenzi F. The role of free flaps in the treatment of persistent scalp osteomyelitis. Neurosurgery. 2006;59(1 Suppl 1):ONS64–7.

    PubMed  Google Scholar 

  4. Greenberg MS. Osteomyelitis of the skull. In: Greenberg MS, editor. Handbook of neurosurgery. 6th ed. New York: Thieme; 2006.

    Google Scholar 

  5. Wilensky AO. Osteomyelitis of the skull. Arch Surg. 1933;27(1):83–158.

    Article  Google Scholar 

  6. Johnson AK, Batra PS. Central skull base osteomyelitis: an emerging clinical entity. Laryngoscope. 2014;124(5):1083–7. doi:10.1002/lary.24440.

    Article  PubMed  Google Scholar 

  7. Patmore H, Jebreel A, Uppal S, Raine CH, McWhinney P. Skull base infection presenting with multiple lower cranial nerve palsies. Am J Otolaryngol. 2010;31(5):376–80. doi:10.1016/j.amjoto.2009.04.001.

    Article  PubMed  Google Scholar 

  8. Mani N, Sudhoff H, Rajagopal S, Moffat D, Axon PR. Cranial nerve involvement in malignant external otitis: implications for clinical outcome. Laryngoscope. 2007;117(5):907–10.

    Article  PubMed  Google Scholar 

  9. Amorosa L, Modugno GC, Pirodda A. Malignant external otitis: review and personal experience. Acta Otolaryngol Suppl. 1996;521:3–16.

    Article  CAS  PubMed  Google Scholar 

  10. Kraus DH, Rehm SJ, Kinney SE. The evolving treatment of necrotizing external otitis. Laryngoscope. 1988;98(9):934–9.

    Article  CAS  PubMed  Google Scholar 

  11. Chandler JR, Grobman L, Quencer R, Serafini A. Osteomyelitis of the base of the skull. Laryngoscope. 1986;96(3):245–51.

    Article  CAS  PubMed  Google Scholar 

  12. McCall TD, Fults DW, Schmidt RH. Use of resorbable collagen dural substitutes in the presence of cranial and spinal infections—report of 3 cases. Surg Neurol. 2008;70(1):92–6. doi:10.1016/j.surneu.2007.04.007.

    Article  PubMed  Google Scholar 

  13. Nathoo N, Nadvi SS, van Dellen JR. Cranial extradural empyema in the era of computed tomography: a review of 82 cases. Neurosurgery. 1999;44(4):748–53.

    Article  CAS  PubMed  Google Scholar 

  14. Bok AP, Peter JC. Subdural empyema: burr holes or craniotomy? A retrospective computerized tomography-era analysis of treatment in 90 cases. J Neurosurg. 1993;78(4):574–8.

    Article  CAS  PubMed  Google Scholar 

  15. Nathoo N, Nadvi SS, Gouws E, van Dellen JR. Craniotomy improves outcomes for cranial subdural empyemas: computed tomography-era experience with 699 patients. Neurosurgery. 2001;49(4):872–7.

    CAS  PubMed  Google Scholar 

  16. Tankell A. Subdural empyema, epidural abscess, and suppurative intracranial thrombophlebitis. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s principles and practices of infectious diseases. 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2005.

    Google Scholar 

  17. Akhaddar A, Elouennass M, Baallal H, Boucetta M. Focal intracranial infections due to Actinomyces species in immunocompetent patients: diagnostic and therapeutic challenges. World Neurosurg. 2010;74(2–3):346–50. doi:10.1016/j.wneu.2010.05.029.

    Article  PubMed  Google Scholar 

  18. Baer WS. The treatment of chronic osteomyelitis with the maggot (larva of the blow fly). J Bone Joint Surg Am. 1931;13:438–75.

    Google Scholar 

  19. McKeever DC. The classic: maggots in treatment of osteomyelitis: a simple inexpensive method. 1933. Clin Orthop Relat Res. 2008;466(6):1329–35. doi:10.1007/s11999-008-0240-5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Galeano M, Ioli V, Colonna M, Risitano G. Maggot therapy for treatment of osteomyelitis and deep wounds: an old remedy for an actual problem. Plast Reconstr Surg. 2001;108(7):2178–9.

    Article  CAS  PubMed  Google Scholar 

  21. Sherman RA, Pechter EA. Maggot therapy: a review of the therapeutic applications of fly larvae in human medicine, especially for treating osteomyelitis. Med Vet Entomol. 1988;2(3):225–30.

    Article  CAS  PubMed  Google Scholar 

  22. Gilead L, Mumcuoglu KY, Ingber A. The use of maggot debridement therapy in the treatment of chronic wounds in hospitalised and ambulatory patients. J Wound Care. 2012;21(2):78. 80, 82–85.

    Article  CAS  PubMed  Google Scholar 

  23. French VM, Cooper RA, Molan PC. The antibacterial activity of honey against coagulase-negative staphylococci. J Antimicrob Chemother. 2005;56(1):228–31.

    Article  CAS  PubMed  Google Scholar 

  24. Ahmed AK, Hoekstra MJ, Hage JJ, Karim RB. Honey-medicated dressing: transformation of an ancient remedy into modern therapy. Ann Plast Surg. 2003;50(2):143–7.

    Article  PubMed  Google Scholar 

  25. Olusanya AA, Gbolahan OO, Aladelusi TO, Akinmoladun VI, Arotiba JT. Clinical parameters and challenges of managing cervicofacial necrotizing fasciitis in a Sub-Saharan Tertiary Hospital. Niger J Surg. 2015;21(2):134–9. doi:10.4103/1117-6806.162572.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Robson V, Dodd S, Thomas S. Standardized antibacterial honey (Medihoney) with standard therapy in wound care: randomized clinical trial. J Adv Nurs. 2009;65(3):565–75. doi:10.1111/j.1365-2648.2008.04923.x.

    Article  PubMed  Google Scholar 

  27. Zeiger B. The use of active Leptospermum honey dressings to re-initiate the wound healing process. Ostomy Wound Manage. 2010;56(1):10.

    PubMed  Google Scholar 

  28. Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015;3, CD005083. doi:10.1002/14651858.CD005083.pub4.

    Google Scholar 

  29. Bondar’ VP, Nekhlopochin SN. [Surgical treatment of osteomyelitis of the frontal bone and the walls of the frontal sinus]. Vestn Otorinolaringol 1989;(1):42–5. Russian.

    Google Scholar 

  30. van Dijk JM, Wagemakers M, Korsten-Meijer AG, Kees Buiter CT, van der Laan BF, Mooij JJ. Cranialization of the frontal sinus—the final remedy for refractory chronic frontal sinusitis. J Neurosurg. 2012;116(3):531–5. doi:10.3171/2011.11.JNS101849.

    Article  PubMed  Google Scholar 

  31. Lang EE, Curran AJ, Patil N, Walsh RM, Rawluk D, Walsh MA. Intracranial complications of acute frontal sinusitis. Clin Otolaryngol Allied Sci. 2001;26(6):452–7.

    Article  CAS  PubMed  Google Scholar 

  32. Germiller JA, Monin DL, Sparano AM, Tom LW. Intracranial complications of sinusitis in children and adolescents and their outcomes. Arch Otolaryngol Head Neck Surg. 2006;132(9):969–76.

    Article  PubMed  Google Scholar 

  33. DelGaudio JM, Evans SH, Sobol SE, Parikh SL. Intracranial complications of sinusitis: what is the role of endoscopic sinus surgery in the acute setting. Am J Otolaryngol. 2010;31(1):25–8. doi:10.1016/j.amjoto.2008.09.009.

    Article  PubMed  Google Scholar 

  34. Herrmann BW, Chung JC, Eisenbeis JF, Forsen Jr JW. Intracranial complications of pediatric frontal rhinosinusitis. Am J Rhinol. 2006;20(3):320–4.

    Article  PubMed  Google Scholar 

  35. Jung J, Lee HC, Park IH, Lee HM. Endoscopic endonasal treatment of a Pott’s puffy tumor. Clin Exp Otorhinolaryngol. 2012;5(2):112–5. doi:10.3342/ceo.2012.5.2.112.

    Article  PubMed  Google Scholar 

  36. Parida PK, Surianarayanan G, Ganeshan S, Saxena SK. Pott’s puffy tumor in pediatric age group: a retrospective study. Int J Pediatr Otorhinolaryngol. 2012;76(9):1274–7. doi:10.1016/j.ijporl.2012.05.018.

    Article  PubMed  Google Scholar 

  37. Bozdemir K, Kutluhan A, Yalçıner G, Cetin H, Bilgen AS, Tarlak B. Treatment of Pott’s Puffy tumor with balloon sinuplasty: report of three cases. Kulak Burun Bogaz Ihtis Derg. 2012;22(6):342–7. doi:10.5606/kbbihtisas.2012.065.

    Article  PubMed  Google Scholar 

  38. Lerner DN, Choi SS, Zalzal GH, Johnson DL. Intracranial complications of sinusitis in childhood. Ann Otol Rhinol Laryngol. 1995;104(4 Pt 1):288–93.

    Article  CAS  PubMed  Google Scholar 

  39. Prasad KC, Prasad SC, Mouli N, Agarwal S. Osteomyelitis in the head and neck. Acta Otolaryngol. 2007;127(2):194–205.

    Article  PubMed  Google Scholar 

  40. DeCesare GE, Deleyiannis FW-B, Losee JE. Reconstruction of osteomyelitis defects of the craniofacial skeleton. Semin Plast Surg. 2009;23(2):119–31. doi:10.1055/s-0029-1214164.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Akhaddar A, Boulahroud O, Naama O, Al-Bouzidi A, Boucetta M. Paraspinal textiloma after posterior lumbar surgery: a wolf in sheep’s clothing. World Neurosurg. 2012;77(2):375–80. doi:10.1016/j.wneu.2011.07.017.

    Article  PubMed  Google Scholar 

  42. Delgado-López PD, Martín-Velasco V, Castilla-Díez JM, Galacho-Harriero AM, Rodríguez-Salazar A. Preservation of bone flap after craniotomy infection. Neurocirugia (Astur). 2009;20(2):124–31.

    Article  Google Scholar 

  43. Wind JJ, Ohaegbulam C, Iwamoto FM, Black PM, Park JK. Immediate titanium mesh cranioplasty for treatment of postcraniotomy infections. World Neurosurg. 2013;79(1):207.e11–3. doi:10.1016/j.wneu.2011.02.013.

    Article  Google Scholar 

  44. Annan M, De Toffol B, Hommet C, Mondon K. Sinking skin flap syndrome (or Syndrome of the trephined): a review. Br J Neurosurg. 2015;29(3):314–8. doi:10.3109/02688697.2015.1012047.

    Article  PubMed  Google Scholar 

  45. Jeyaraj P. Importance of early cranioplasty in reversing the “syndrome of the trephine/motor trephine syndrome/sinking skin flap syndrome”. J Maxillofac Oral Surg. 2015;14(3):666–73. doi:10.1007/s12663-014-0673-1.

    Article  PubMed  Google Scholar 

  46. Bruce JN, Bruce SS. Preservation of bone flaps in patients with postcraniotomy infections. J Neurosurg. 2003;98(6):1203–7.

    Article  PubMed  Google Scholar 

  47. Auguste KI, McDermott MW. Salvage of infected craniotomy bone flaps with the wash-in, wash-out indwelling antibiotic irrigation system. Technical note and case series of 12 patients. J Neurosurg. 2006;105(4):640–4.

    Article  PubMed  Google Scholar 

  48. Kshettry VR, Hardy S, Weil RJ, Angelov L, Barnett GH. Immediate titanium cranioplasty after debridement and craniectomy for postcraniotomy surgical site infection. Neurosurgery. 2012;70(1 Suppl Operative):8–14. doi:10.1227/NEU.0b013e31822fef2c. discussion 14–5.

    PubMed  Google Scholar 

  49. Baumeister S, Peek A, Friedman A, Levin LS, Marcus JR. Management of postneurosurgical bone flap loss caused by infection. Plast Reconstr Surg. 2008;122(6):195e–208. doi:10.1097/PRS.0b013e3181858eee.

    Article  PubMed  Google Scholar 

  50. Seitz IA, Adler N, Odessey E, Reid RR, Gottlieb LJ. Latissimus dorsi/rib intercostal perforator myo-osseocutaneous free flap reconstruction in composite defects of the scalp: case series and review of literature. J Reconstr Microsurg. 2009;25(9):559–67. doi:10.1055/s-0029-1236834.

    Article  PubMed  Google Scholar 

  51. Tutela JP, Banta JC, Boyd TG, Kelishadi SS, Chowdhry S, Little JA. Scalp reconstruction: a review of the literature and a unique case of total craniectomy in an adult with osteomyelitis of the skull. Eplasty. 2014;14:e27.

    PubMed  PubMed Central  Google Scholar 

  52. Hoffman JF. Management of scalp defects. Otolaryngol Clin North Am. 2001;34(3):571–82.

    Article  CAS  PubMed  Google Scholar 

  53. Wieslander JB. Tissue expansion in the head and neck. A 6-year review. Scand J Plast Reconstr Surg Hand Surg. 1991;25(1):47–56.

    Article  CAS  PubMed  Google Scholar 

  54. Leedy JE, Janis JE, Rohrich RJ. Reconstruction of acquired scalp defects: an algorithmic approach. Plast Reconstr Surg. 2005;116(4):54e–72.

    Article  PubMed  CAS  Google Scholar 

  55. Lu Y, Cen Y, Qing Y, Wang H. [Surgical treatment of chronic osteomyelitis of the skull]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011;25(5):558–61. Chinese.

    PubMed  Google Scholar 

  56. Beasley NJ, Gilbert RW, Gullane PJ, Brown DH, Irish JC, Neligan PC. Scalp and forehead reconstruction using free revascularized tissue transfer. Arch Facial Plast Surg. 2004;6(1):16–20.

    Article  PubMed  Google Scholar 

  57. Uppal HS, Issa F, Byren I, Johnson D. A case of pancalvarial osteomyelitis: diagnosis and management. J Plast Reconstr Aesthet Surg. 2010;63(2):e159–60. doi:10.1016/j.bjps.2009.05.015.

    Article  PubMed  Google Scholar 

  58. Kim JC, Hadlock T, Varvares MA, Cheney ML. Hair-bearing temporoparietal fascial flap reconstruction of upper lip and scalp defects. Arch Facial Plast Surg. 2001;3(3):170–7.

    Article  CAS  PubMed  Google Scholar 

  59. Guerrissi JO. Reconstruction of large defects in the scalp with fasciocutaneous flaps. Scand J Plast Reconstr Surg Hand Surg. 1999;33(2):217–24.

    Article  CAS  PubMed  Google Scholar 

  60. Lutz BS. Scalp and forehead reconstruction. Semin Plast Surg. 2010;24(2):171–80. doi:10.1055/s-0030-1255334.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Varvares MA, Lin D, Hadlock T, Azzizadeh B, Gliklich R, Rounds M, Rocco J, Deschler DG, Fabian R, Cheney ML. Success of multiple, sequential, free tissue transfers to the head and neck. Laryngoscope. 2005;115(1):101–4.

    Article  PubMed  Google Scholar 

  62. Lin YT, Chen CT, Lai JP. Post-traumatic fronto-ethmoid osteomyelitis treated with free muscle transfer. J Plast Reconstr Aesthet Surg. 2010;63(6):963–9. doi:10.1016/j.bjps.2009.03.017.

    Article  PubMed  Google Scholar 

  63. Newman MI, Hanasono MM, Disa JJ, Cordeiro PG, Mehrara BJ. Scalp reconstruction: a 15-year experience. Ann Plast Surg. 2004;52(5):501–6.

    Article  PubMed  Google Scholar 

  64. Editorial Board of Plastic and Reconstructive Surgery. Management of a complex scalp defect. Plast Reconstr Surg. 2008;122(2):623–5. doi:10.1097/PRS.0b013e31817d7f91.

    Article  CAS  Google Scholar 

  65. Kurokawa M, Inoue K. One stage reconstruction of the skull defect following chronic osteomyelitis using a serratus anterior muscle rib osteomyocutaneous free flap. Eur J Plast Surg. 1994;17(4):204–7.

    Article  Google Scholar 

  66. Chang N, Mathes SJ. Comparison of the effect of bacterial inoculation in musculocutaneous and random-pattern flaps. Plast Reconstr Surg. 1982;70(1):1–10.

    Article  CAS  PubMed  Google Scholar 

  67. Fisher J, Wood MB. Experimental comparison of bone revascularization by musculocutaneous and cutaneous flaps. Plast Reconstr Surg. 1987;79(1):81–90.

    Article  CAS  PubMed  Google Scholar 

  68. Powers AK, Neal MT, Argenta LC, Wilson JA, DeFranzo AJ, Tatter SB. Vacuum-assisted closure for complex cranial wounds involving the loss of dura mater. J Neurosurg. 2013;118(2):302–8. doi:10.3171/2012.10.JNS112241.

    Article  PubMed  Google Scholar 

  69. Prince N, Blackburn S, Murad G, Mast B, Sapountzis S, Shaw C, Werning J, Singhal D. Vacuum-assisted closure therapy to the brain: a safe method for wound temporization in composite scalp and calvarial defects. Ann Plast Surg. 2015;74 Suppl 4:S218–21. doi:10.1097/SAP.0000000000000374.

    Article  CAS  PubMed  Google Scholar 

  70. Ahmed O, Storey CM, Zhang S, Chelly MR, Yeoh MS, Nanda A. Vacuum-assisted closure of necrotic and infected cranial wound with loss of dura mater: a technical note. Surg Neurol Int. 2015;6:11. doi:10.4103/2152-7806.149846.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Subotic U, Kluwe W, Oesch V. Community-associated methicillin-resistant Staphylococcus aureus-infected chronic scalp wound with exposed dura in a 10-year-old boy: vacuum-assisted closure is a feasible option: case report. Neurosurgery. 2011;68(5):E1481–3. doi:10.1227/NEU.0b013e318210c7fb.

    PubMed  Google Scholar 

  72. Eppley BL. Biomechanical testing of alloplastic PMMA cranioplasty materials. J Craniofac Surg. 2005;16(1):140–3.

    Article  PubMed  Google Scholar 

  73. Afifi AM, Gordon CR, Pryor LS, Sweeney W, Papay FA, Zins JE. Calcium phosphate cements in skull reconstruction: a meta-analysis. Plast Reconstr Surg. 2010;126(4):1300–9. doi:10.1097/PRS.0b013e3181ead057.

    Article  CAS  PubMed  Google Scholar 

  74. Jalbert F, Boetto S, Nadon F, Lauwers F, Schmidt E, Lopez R. One-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants. J Craniomaxillofac Surg. 2014;42(2):141–8. doi:10.1016/j.jcms.2013.04.001.

    Article  CAS  PubMed  Google Scholar 

  75. Cabraja M, Klein M, Lehmann TN. Long-term results following titanium cranioplasty of large skull defects. Neurosurg Focus. 2009;26(6):E10. doi:10.3171/2009.3.FOCUS091.

    Article  PubMed  Google Scholar 

  76. Matsuno A, Tanaka H, Iwamuro H, Takanashi S, Miyawaki S, Nakashima M, Nakaguchi H, Nagashima T. Analyses of the factors influencing bone graft infection after delayed cranioplasty. Acta Neurochir (Wien). 2006;148(5):535–40.

    Article  CAS  Google Scholar 

  77. Joffe J, Harris M, Kahugu F, Nicoll S, Linney A, Richards R. A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome. Br J Neurosurg. 1999;13(6):576–80.

    Article  CAS  PubMed  Google Scholar 

  78. Lai JB, Sittitavornwong S, Waite PD. Computer-assisted designed and computer-assisted manufactured polyetheretherketone prosthesis for complex fronto-orbito-temporal defect. J Oral Maxillofac Surg. 2011;69(4):1175–80. doi:10.1016/j.joms.2010.05.034.

    Article  PubMed  Google Scholar 

  79. Dean D, Min KJ, Bond A. Computer aided design of large-format prefabricated cranial plates. J Craniofac Surg. 2003;14(6):819–32.

    Article  PubMed  Google Scholar 

  80. Chen ST, Chang CJ, Su WC, Chang LW, Chu IH, Lin MS. 3-D titanium mesh reconstruction of defective skull after frontal craniectomy in traumatic brain injury. Injury. 2015;46(1):80–5. doi:10.1016/j.injury.2014.09.019.

    Article  PubMed  Google Scholar 

  81. Piitulainen JM, Kauko T, Aitasalo KM, Vuorinen V, Vallittu PK, Posti JP. Outcomes of cranioplasty with synthetic materials and autologous bone grafts. World Neurosurg. 2015;83(5):708–14. doi:10.1016/j.wneu.2015.01.014.

    Article  PubMed  Google Scholar 

  82. Artico M, Ferrante L, Pastore FS, Ramundo EO, Cantarelli D, Scopelliti D, Iannetti G. Bone autografting of the calvaria and craniofacial skeleton: historical background, surgical results in a series of 15 patients, and review of the literature. Surg Neurol. 2003;60(1):71–9.

    Article  PubMed  Google Scholar 

  83. Psillakis JM, Nocchi VL, Zanini SA. Repair of large defect of frontal bone with free graft of outer table of parietal bones. Plast Reconstr Surg. 1979;64(6):827–30.

    Article  CAS  PubMed  Google Scholar 

  84. Psillakis JM, Grotting JC, Casanova R, Cavalcante D, Vasconez LO. Vascularized outer-table calvarial bone flaps. Plast Reconstr Surg. 1986;78(3):309–17.

    Article  CAS  PubMed  Google Scholar 

  85. Wiggins A, Austerberry R, Morrison D, Ho KM, Honeybul S. Cranioplasty with custom-made titanium plates—14 years experience. Neurosurgery. 2013;72(2):248–56. doi:10.1227/NEU.0b013e31827b98f3.

    Article  PubMed  Google Scholar 

  86. Knöringer P. [Treatment of bone infection in the area of the skull]. Unfallchirurgie. 1986;12(2):81–92. German.

    Article  PubMed  Google Scholar 

  87. Gupta S, Vachhrajani S, Kulkarni AV, Taylor MD, Dirks P, Drake JM, Rutka JT. Neurosurgical management of extraaxial central nervous system infections in children. J Neurosurg Pediatr. 2011;7(5):441–51. doi:10.3171/2011.2.PEDS09500.

    PubMed  Google Scholar 

  88. Josan VA, Sgouros S, Walsh AR, Dover MS, Nishikawa H, Hockley AD. Cranioplasty in children. Childs Nerv Syst. 2005;21(3):200–4.

    Article  CAS  PubMed  Google Scholar 

  89. Lee C, Antonyshyn OM, Forrest CR. Cranioplasty: indications, technique, and early results of autogenous split skull cranial vault reconstruction. J Craniomaxillofac Surg. 1995;23(3):133–42.

    Article  CAS  PubMed  Google Scholar 

  90. Rish BL, Dillon JD, Meirowsky AM, Caveness WF, Mohr JP, Kistler JP, Weiss GH. Cranioplasty: a review of 1030 cases of penetrating head injury. Neurosurgery. 1979;4(5):381–5.

    Article  CAS  PubMed  Google Scholar 

  91. Shaffrey ME, Persing JA, Shaffrey CI, Delashaw JB, Jane JA. Craniofacial reconstruction. In: Apuzzo MLJ, editor. Brain surgery: complication and avoidance management. New York: Churchill Livingstone; 1993.

    Google Scholar 

  92. Prolo DJ. Cranial defects and cranioplasty. In: Wilkins RH, Rengachary SS, editors. Neurosurgery. 2nd ed. New York: McGraw-Hill; 1996.

    Google Scholar 

  93. Foster RD, Antonyshyn OM, Lee C, Holland M, Fazl M. Cranioplasty: indications, techniques, and results. In: Schmideck HH, editor. Schmidek and sweet operative neurosurgical techniques. Philadelphia: WB Saunders; 2000.

    Google Scholar 

  94. Kshettry VR, Angelov L. Technical note regarding immediate titanium mesh cranioplasty for postcraniotomy infections. World Neurosurg. 2014;81(3–4):e16. doi:10.1016/j.wneu.2013.08.057.

    Article  PubMed  Google Scholar 

  95. Hirase Y, Kojima T, Kinoshita Y, Bang HH, Sakaguchi T, Kijima M. Composite reconstruction for chest wall and scalp using multiple ribs-latissimus dorsi osteomyocutaneous flaps as pedicled and free flaps. Plast Reconstr Surg. 1991;87(3):555–61.

    Article  CAS  PubMed  Google Scholar 

  96. Ueda K, Harashina T, Inoue T, Tanaka I, Harada T. Microsurgical scalp and skull reconstruction using a serratus anterior myo-osseous flap. Ann Plast Surg. 1993;31(1):10–4.

    Article  CAS  PubMed  Google Scholar 

  97. Lee SJ, Weon YC, Cha HJ, Kim SY, Seo KW, Jegal Y, Ahn JJ, Ra SW. A case of atypical skull base osteomyelitis with septic pulmonary embolism. J Korean Med Sci. 2011;26(7):962–5. doi:10.3346/jkms.2011.26.7.962.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Clark MP, Pretorius PM, Byren I, Milford CA. Central or atypical skull base osteomyelitis: diagnosis and treatment. Skull Base. 2009;19(4):247–54. doi:10.1055/s-0028-1115325.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Cavel O, Fliss DM, Segev Y, Zik D, Khafif A, Landsberg R. The role of the otorhinolaryngologist in the management of central skull base osteomyelitis. Am J Rhinol. 2007;21(3):281–5.

    Article  PubMed  Google Scholar 

  100. Cunningham M, Yu VL, Turner J, Curtin H. Necrotizing otitis externa due to Aspergillus in an immunocompetent patient. Arch Otolaryngol Head Neck Surg. 1988;114(5):554–6.

    Article  CAS  PubMed  Google Scholar 

  101. Ridder GJ, Breunig C, Kaminsky J, Pfeiffer J. Central skull base osteomyelitis: new insights and implications for diagnosis and treatment. Eur Arch Otorhinolaryngol. 2015;272(5):1269–76. doi:10.1007/s00405-014-3390-y.

    Article  PubMed  Google Scholar 

  102. Cunningham C. Transanal endoscopic microsurgery. Recent Results Cancer Res. 2014;203:31–8. doi:10.1007/978-3-319-08060-4_4.

    Article  PubMed  Google Scholar 

  103. Stodulski D, Kowalska B, Stankiewicz C. Otogenic skull base osteomyelitis caused by invasive fungal infection. Case report and literature review. Eur Arch Otorhinolaryngol. 2006;263(12):1070–6.

    Article  PubMed  Google Scholar 

  104. Blyth CC, Gomes L, Sorrell TC, da Cruz M, Sud A, Chen SC. Skull-base osteomyelitis: fungal vs. bacterial infection. Clin Microbiol Infect. 2011;17(2):306–11. doi:10.1111/j.1469-0691.2010.03231.x.

    Article  CAS  PubMed  Google Scholar 

  105. Laccourreye L, Halimi P, Bonfils P, Laccourreye O. Atypical pseudotumoral osteomyelitis of the skull base. Otolaryngol Head Neck Surg. 2007;137(3):524–5.

    Article  PubMed  Google Scholar 

  106. Ducic Y. Management of osteomyelitis of the anterior skull base and craniovertebral junction. Otolaryngol Head Neck Surg. 2003;128(1):39–42.

    Article  PubMed  Google Scholar 

  107. Adcock PM, Marshall GS. Osteomyelitis of the axial skeleton and the flat and small bones. Semin Pediatr Infect Dis. 1997;8:234–41.

    Article  Google Scholar 

  108. Akhaddar A. Infective complications. In: Di Rocco C, Turgut M, Jallo G, Martinez-Lage DJF, editors. Complications of CSF shunting in hydrocephalus. Switzerland: Springer International; 2015.

    Google Scholar 

  109. Larsson A, Engström M, Uusijärvi J, Kihlström L, Lind F, Mathiesen T. Hyperbaric oxygen treatment of postoperative neurosurgical infections. Neurosurgery. 2002;50(2):287–95.

    PubMed  Google Scholar 

  110. Martel J, Duclos JY, Darrouzet V, Guyot M, Bébéar JP. [Malignant or necrotizing otitis externa: experience in 22 cases]. Ann Otolaryngol Chir Cervicofac. 2000;117(5):291. French.

    CAS  PubMed  Google Scholar 

  111. Narozny W, Kuczkowski J, Mikaszewski B. Infectious skull base osteomyelitis—still a life-threatening disease. Otol Neurotol. 2006;27(7):1047–8.

    Article  PubMed  Google Scholar 

  112. Davis JC, Gates GA, Lerner C, Davis MG, Mader JT, Dinesman A. Adjuvant hyperbaric oxygen in malignant external otitis. Arch Otolaryngol Head Neck Surg. 1992;118(1):89–93.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery Avicenne Military Hospital of Marrakech, University of Mohammed V in Rabat, Marrakech, Morocco

    Ali Akhaddar

Authors
  1. Ali Akhaddar
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Akhaddar, A. (2016). General Considerations and Surgical Therapy. In: Cranial Osteomyelitis. Springer, Cham. https://doi.org/10.1007/978-3-319-30268-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-30268-3_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-30266-9

  • Online ISBN: 978-3-319-30268-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation