{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T10:32:35Z","timestamp":1791369155680,"version":"4.3.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The role of surgery in lateral skull base osteomyelitis (SBO) is controversial. Surgical intervention is often requested by consulting services in the interest of additional culture data to inform medical management. However, whether surgery alters subsequent antibiotic treatment or modifies disease outcome remains unknown. The aim of this study was to investigate the role of surgical intervention in the treatment of SBO by (1) comparing nonsurgical and surgical culture data and (2) assessing clinical outcomes and treatment course following surgical intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The electronic record was queried for all patients with SBO who presented to a single institution over a 16\u2010year period (2007\u20102023). Information recorded included history and exam, bedside and intraoperative culture data, antibiotic course, and disease outcomes. Primary outcome measures included change in medical management based on intraoperative cultures, recurrence rates, and mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty patients (41 ears, average age 73\u2009\u00b1\u200913 years) met inclusion criteria. Out of 13 (32%) patients who underwent surgical intervention, one intraoperative culture changed the antibiotic course due to identification of resistance to the original antibiotic used. Surgery did not demonstrate a benefit in overall mortality (23% vs 18%, <jats:italic>P<\/jats:italic>\u2009=\u20090.36) or facial nerve function (33% vs 50%, <jats:italic>P<\/jats:italic>\u2009=\u20090.56) compared to medical management, and was associated with increased recurrence rates (54% vs 11%, <jats:italic>P<\/jats:italic>\u2009=\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical cultures rarely changed antibiotic selection. Surgical debridement in treatment\u2010refractory SBO was also not associated with improvement in recurrence or mortality rates, though this may reflect underlying differences in disease severity.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.661","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T04:54:51Z","timestamp":1707713691000},"page":"197-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reassessing the Utility of Surgical Intervention for Skull Base Osteomyelitis: A 16\u2010Year Experience"],"prefix":"10.1002","volume":"171","author":[{"given":"Beatrice C.","family":"Go","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Eliades","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery &amp; Communication Sciences Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Brant","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Corporal Michael J. Crescenz VA Medical Center Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas C.","family":"Bigelow","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ruckenstein","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany P.","family":"Hwa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196808000-00002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200310000-00002"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489418778056"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26401"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.21.11.1077"},{"issue":"1","key":"e_1_2_8_7_1","first-page":"64","article-title":"Malignant otitis externa: a review","volume":"9","author":"Bhandary S","year":"2002","journal-title":"Pac Health Dialog"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106002775"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200209000-00017"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002723"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5540900301"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2016.00612"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2009.08.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(88)90592-X"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28409"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.04.005"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001986"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e3182804aee"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215119000604"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2017.4399"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joto.2019.01.003"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814528301"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2020.7709"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000839"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:36:19Z","timestamp":1760967379000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,12]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1002\/ohn.661"],"URL":"https:\/\/doi.org\/10.1002\/ohn.661","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,12]]},"assertion":[{"value":"2023-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}