Role of triple phase bone scan in evaluation of skull base osteomyelitis: A retrospective case series done at AIIMS Rishikesh

Skull base osteomyelitis (SBO) is a relatively uncommon condition that typically develops as a result of untreated infection of the temporal bone region that extends interiorly to the infratemporal fossa, most frequently as a result of necrotizing external otitis brought on by Pseudomonas aeruginosa in a diabetic patient. After an intravenous tracer injection, a triple phase BS (dynamic flow followed by static blood-pool and 3 hour delayed imaging) and SPECT/CT of the skull were conducted (Tc-99m MDP). The most frequent initial complaint was ear discharge (8/10), followed by fever (6/10), whereas facial nerve palsy and diplopia were observed in 4/10 and 2/10 individuals, respectively. It was shown by SPECT/CT in the mastoid temporal (4), petrous (4), squamous temporal (1), sphenoid (2), zygomatic (3), basi-occiput (2), maxillary bone (2) and showed destructive changes in seven. Our study reveals that when combined with clinical characteristics, microbiological culture, structural imaging, and patient's immunocompromised status, TPBS with SPECT/CT exhibits great diagnostic performance as a means of diagnosing SBO