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In the current manuscript, we present our experience with three diagnostically difficult cases of the disease to highlight this dangerous condition.
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Changing trends in the clinical picture of the disease, including a declining prevalence of DM and atypical causative agents, have been reported recently. The other rare etiologic conditions also mentioned in the literature are an infection of the middle ear or previous mastoidectomy. In the past, its cause was almost always necrotizing external otitis (NEO), especially in older adults with diabetes mellitus (DM) and patients with immunosuppressive conditions. Fatal cases of temporal bone osteomyelitis have been described previously. Temporal bone osteomyelitis (TBO) is a dangerous condition, and the proper treatment at the appropriate time is extremely important. This manuscript is dedicated to the memory of a great, internationally renowned, otoneurologic surgeon and researcher John K. Surgery was used for the presence of bone sequestra and infratemporal abscess. Imaging should be performed early to detect osteolytic lesions of the skull base. The disorder might be related to the initial inflammatory process in the middle ear with further direct spreading of infection through defects in the bony walls to deep temporal bone structures.
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The disease can develop in nondiabetic patients. Neoplasm and granulomatous inflammation were excluded by multiple biopsies. The diagnosis was based on clinical symptoms, otoscopic findings, and findings on computed tomography or magnetic resonance imaging. To emphasize the importance of a clinical suspicion of this dangerous condition, our experience with three difficult cases is presented. Changing trends of the disease make a differential diagnosis difficult. Temporal bone osteomyelitis is a serious life-threatening condition-a quick and proper diagnosis is needed to start treatment and reduce morbidity and mortality.