{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T14:49:42Z","timestamp":1780152582976,"version":"3.54.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Study aimed to ole of surgery along with antimicrobials to improve clinical outcomes in treating refractory cases of skull base osteomyelitis (SBO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective observational study in a tertiary care centre with 70 SBO patients meeting eligibility criteria. The study population comprised 35 patients refractory to systemic antimicrobials of at least 4\u2009weeks duration who later underwent surgery in addition to medication (surgical group). They were compared with a medical group that responded to medications alone. The outcome variables studied were the resolution of clinical features (pain, discharge, radiology, and inflammatory markers), culture yield, and total duration of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      According to our study, relief of pain was faster in the surgical group (1.66 against 4.57\u2009months) with statistical significance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Relief of symptoms (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), radiological improvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and normalising of inflammatory markers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were better in the surgical group than in the medical group. The duration of treatment was an average of 9.2\u2009months in the surgical group compared to 11.3\u2009months in the medical group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Microbial culture from deep tissue sampling was positive in 24 surgical patients (68.57%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The treatment response in selected patients of refractory SBO who underwent surgery along with antimicrobials was better than the group who responded to antimicrobials alone. Surgery provided higher microbial yield resulting in culture\u2010specific antimicrobials. The surgical group observed faster relief of symptoms, reduced hospital stay, and total treatment duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14188","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T08:44:49Z","timestamp":1717404289000},"page":"640-651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Role of surgery along with antimicrobials in refractory skull base osteomyelitis\u2014A prospective observational study"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4179-9720","authenticated-orcid":false,"given":"Bini","family":"Faizal","sequence":"first","affiliation":[{"name":"Department of ENT, Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeedham University  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-1795","authenticated-orcid":false,"given":"Lakshmi","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of ENT, Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeedham University  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4059-3018","authenticated-orcid":false,"given":"Jayanthy","family":"Pavithran","sequence":"additional","affiliation":[{"name":"Department of ENT, Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeedham University  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1873-1488","authenticated-orcid":false,"given":"Merlin","family":"Moni","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeedham University  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-1119","authenticated-orcid":false,"given":"V. S.","family":"Sheejamol","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeedham University  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196808000-00002"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0196-0709(80)80016-0"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-019-0331-7"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(20)30316-9"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0000000000001187"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjorl.2020.09.012"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-018-1426-0"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0022215100101562"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed8050254"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-90-481-9039-3_28"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2021.06.015"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1694-7"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2016.00612"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2013.12.005"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016489609137954x"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir842"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-28766-7_8"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0185(199704)"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2011.01.020"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-05842-x"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102894"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39518"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2023.06.004"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2020.04.002"},{"issue":"1","key":"e_1_2_13_26_1","first-page":"E16","article-title":"The role of surgery in necrotizing otitis externa","volume":"96","author":"Gruber M","year":"2017","journal-title":"Ear Nose Throat J"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.14188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T20:55:32Z","timestamp":1722977732000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.14188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,3]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/coa.14188"],"URL":"https:\/\/doi.org\/10.1111\/coa.14188","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/COA.14188\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v4\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14188\/v4\/response1","asserted-by":"object"}]},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,3]]},"assertion":[{"value":"2022-12-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}