Intracranial condylar displacement: An unusual non-traumatic case of skull base osteomyelitis and temporal lobe abscess

Abstract

We describe a 58-year-old man with a unique complication of chronic mandibular osteomyelitis. He presented with a unilateral facial nerve palsy and a non-traumatic dislocation of the mandibular condyle into the middle cranial fossa combined with a temporal lobe abscess. An odontogenic infection had already been festering for 18 months. After stereotactic puncture, P. Aeruginosa was cultured out of the brain abscess and the patient was treated with a culture-based antibiotic therapy followed by condylectomy and myofascial temporalis flap. One year after the surgery, the patient had a partial ossification of the glenoid fossa, recovered mouth opening and sufficient function. This report shows that the rare complication of chronic mandibular osteomyelitis with concurrent brain abscess can be treated successfully using a combination of aggressive long-term culture-based antibiotic treatment and a multidisciplinary surgical approach.

Keywords

• Brain abscess
• Dislocation condyle
• Middle cranial fossa
• Skull base osteomyelitis