糖尿病合并颅底骨髓炎机制及诊疗策略研究OA

Skull base osteomyelitis(SBO)is primarily caused by the spread of infection from adjacent tissues(such as necrotizing otitis externa and sinusitis)to the skull base.It is a relatively rare and serious disease,typically presenting with ear pain,otorrhea,and neurological impairment.The recurrence rate is as high as 15%-20%,with a significant mortality rate.Diabetes mellitus is a core risk factor for SBO,with approximately 46%-74.6%of patients having comorbid diabetes.The hyperglycemic state increases susceptibility to SBO through multiple pathological mechanisms.This article analyzes the mechanisms underlying the high incidence of SBO in diabetic patients from three aspects:impaired immune defense,enhanced pathogen invasiveness,and the chronic inflammatory state associated with diabetes.It also discusses potential management strategies,including anti-infective therapy,precise glycemic control,and multidisciplinary collaboration.Integrated Chinese and Western medicine interventions,along with the traditional Chinese medicine concept of"preventive treatment before disease onset",show broad application prospects.Furthermore,the clinical data of three patients with diabetes and SBO admitted since August 2021 were analyzed.The results indicate that patients'conditions improve with appropriate antibiotic use and effective glycemic control,whereas the disease progresses otherwise.This review aims to provide a reference for the clinical diagnosis and treatment of SBO complicated with diabetes.