Observational studyIndian journal of ophthalmology2026
Nerve-rattling infections! Clinical and radiological tracing of cranial nerve palsies to infectious skull base osteomyelitis.
Observational study in Indian journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo analyze skull base osteomyelitis as a cause of isolated and multiple cranial nerve palsies. Report presentations of otogenic and non-otogenic types. Emphasize the importance of neuroimaging with contrast at the first visit.
designSingle-center retrospective observational study.
settingInstitutional. STUDY POPULATION: A total of 276 patients with cranial nerve palsies over a period of four months. Of these, 20 patients with SBO were included in the study. OBSERVATION PROCEDURE: Complete ocular examination and magnetic resonance imaging (MRI) of the brain and orbit with contrast for all patients.
main outcome measureRadiological/microbiological diagnosis of SBO.
resultsMost of our patients were between 70 and 75 years. Time from the onset of symptoms to presentation was between one week and one month. A total of 75% had diabetes mellitus. A total of 90% had unilateral presentation. Most common presenting symptom was double vision and headache seen in 45%. A total of 70% had a non-otogenic source of infection. Sphenoid sinus was involved in 50%. MRI of brain and orbit with contrast showed sinusitis in 45% and otomastoiditis in 35%. Fungi were isolated on biopsy in 30%, bacteria in 15%, acid-fast bacilli in 5%. Intravenous antibiotics were given to 55% and intravenous antifungal was given to 25%. Transnasal sinus surgery was performed in 30%.
conclusionIsolated cranial palsy does not exclude infectious etiology even if patient has comorbidities like uncontrolled diabetes, particularly if associated with headache and pain. Hence, neuroimaging with contrast is required.
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