坏死性外耳道炎继发颈椎骨髓炎1例并文献复习  

Cervical vertebral osteomyelitis secondary to necrotizing otitis externa:a case report and review of literature

作　　者：田俊 刘良发[1] 白佳麒 TIAN Jun;LIU Liangfa;BAI Jiaqi(Department of Otorhinolaryngology&Head and Neck Surgery,The Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,北京100050

出　　处：《山东大学耳鼻喉眼学报》2022年第4期1-5,11,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨坏死性外耳道炎继发颈椎骨髓炎的诊疗方法及临床特点。方法回顾性分析1例糖尿病老年患者坏死性外耳道炎合并C2-C6颈椎椎体骨髓炎的病历资料并检索文献,总结其临床表现、诊断、治疗方法及预后。结果检索获得2005~2022年国内外发表的5篇文献,加上本例患者共纳入4个病例,其中男3例、女1例,54~72岁,除1例有头颈部放疗史外其余3例均合并糖尿病,病变范围均广泛,累及2~5个颈椎椎体,病原体为不同细菌,经过系统治疗后,3例(75%)死亡,与细菌耐药、患者依从性差及全身健康状况差可能有关。结论坏死性外耳道炎病变可从颅底骨髓炎进一步扩展至颈椎骨髓炎危及生命,需要积极治疗。Objective To outline and analyze the clinical features and treatment option of cervical osteomyelitis secondary to necrotizing otitis externa.Methods We performed a retrospective review,along with literature review,of a case of C2-C6 osteomyelitis secondary to a necrotizing otitis externa in a diabetic patient,in order to outline its clinical manifestation,diagnosis,treatment option and prognosis.Results A total of five relevant studies published in Chinese and English from 2005 to 2022 were reviewed,and four cases(including the case presented in this study)were analyzed.The four cases involved three men and one woman(age range:54-72 years).Only one patient had a history of head and neck radiotherapy,the remaining three were known diabetic patients.The lesions were extensive,involving two to five vertebral bodies.The causative pathogens isolated were all bacteria;however,the strains varied among the cases.After a systematic treatment,three patients(75%)succumbed to the disease as a result of bacterial resistance,poor compliance to medications,and severe comorbidity.Conclusion The lesions of necrotizing otitis externa can extend from the skull base to the cervical vertebrae,causing cervical osteomyelitis:a life-threatening condition that requires an aggressive treatment.

关 键 词：坏死性外耳道炎 骨髓炎 糖尿病 颈椎 

分 类 号：R764.11[医药卫生—耳鼻咽喉科]