Evidence map›Paper›PMID 41026440›Full record

ArticleLa Radiologia medica2025

Association between type of skull base osteomyelitis (SBO), source, and infection spread in patients with proven SBO.

David Timaran Montenegro, Kamand Khalaj, Elham Tavakkol, Luis Nunez, Andres Rodriguez, Salmaan Jeelani, Kayli Quinton, Roy Riascos, Jose Gavito-Higuera

Abstract read
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In one paragraph

Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Optimizing pathogen detection in skull base osteomyelitis: a comparative analysis of swab versus biopsy sampling.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

David Timaran MontenegroDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Kamand KhalajDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Elham TavakkolDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Luis NunezDepartment of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Andres RodriguezDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Salmaan JeelaniDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Kayli QuintonMcGovern Medical School, Houston, TX, USA.
Roy RiascosDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA.
Jose Gavito-HigueraDivision of Neuroradiology, Department of Diagnostic and Interventional Imaging, McGovern Medical School, UTHealth Houston, 6431 Fannin Street MSB 2130B, Houston, TX, USA. jose.gavitohiguera@uth.tmc.edu.ORCID http://orcid.org/0009-0001-7806-9935

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSkull base osteomyelitis (SBO) is a challenging diagnosis with a variety of nonspecific clinical manifestations and imaging findings. This study aims to determine the association between the type of SBO and the source and infection spread in patients with histopathology/culture-proven SBO. MATERIALS AND

methodsA retrospective analysis of 55 patients with suspected SBO was conducted. Twenty-two patients (40%) were excluded because either histology resulted in neoplasia without associated infection (2[9%]) or imaging findings were negative for SBO. An additional nine patients were excluded due to negative cultures and nonspecific inflammatory changes on histology without clinical signs of sepsis. A total of 24 patients met inclusion criteria with either a positive culture (13[54.1%] or histopathologic inflammation with signs of infection (11[45.9%]).

resultsBacterial SBO was identified in 13 patients (54.1%) and fungal SBO in two patients (8.33%). Typical SBO (TSBO) was observed in 12 patients (50%). Twelve patients (50%) had typical SBO (TSBO), and the remaining 12 (50%) presented with central or atypical SBO (ASBO). The nasopharynx was identified as the primary source of infection in one-third of ASBO cases. In this group, the infection frequently extended to the masticator space (75%, p = 0.01) and carotid space (75%, p < 0.01), with internal carotid artery thrombosis seen in half of these patients (p = 0.06). Temporomandibular joint involvement was also observed (58.3%, p = 0.2). On MRI, peri-clival soft tissue enhancement (66%, p = 0.03) and sphenoid body bone marrow edema (50%, p = 0.08) were prominent findings in ASBO cases.

conclusionCentral or atypical SBO accounted for half of the confirmed cases in this study and was frequently associated with extensive spread to adjacent deep neck spaces and vascular complications. Characteristic MRI findings such as peri-clival soft tissue enhancement and sphenoid body marrow edema may aid early recognition. Identifying the nasopharynx as a common infection source and recognizing these imaging patterns can support earlier diagnosis and tailored treatment strategies, potentially improving patient outcomes.

Indexed as

OsteomyelitisSkull BaseAdolescentAdultAgedAged, 80 and overFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedCentral SBOSBO complicationsSkull base imagingSkull base osteomyelitis (SBO)Typical/lateral SBO

Identifiers

PMID41026440

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.