A case of atlantoaxial instability following skull base osteomyelitis: Tips for diagnosis and management.

Skull base osteomyelitis is a rare but dangerous consequence of untreated malignant otitis externa. Pseudomonas aeruginosa is responsible for most cases with typical presentation. Here, we discuss a diabetic 54‐year‐old female presented with malignant otitis externa and bilateral facial paresis followed by cervical spondylitis and C1‐C2 instability. Skull base osteomyelitis confirmed by clinical presentation, imaging, and laboratory data. Fortunately, she responded well to antibacterial and antifungal therapy. Due to limited data, there is no confirmed standard of treatment for cervical instability secondary to SBO. It seems antibiotic therapy is the mainstay of treatment. In case of poor response to antibiotic therapy, surgical intervention is inevitable. This article introduces the first case of SBO‐related AAI successfully managed with conservative treatment. Skull base osteomyelitis (SBO) following malignant otitis externa (MOE) is not common but can be a debilitating condition. Appropriate and early diagnosis is crucial for preventing morbidity and mortality. Cranial nerves paresis and atlantoaxial instability are rare manifestation and are in favor of skull base involvement. [ABSTRACT FROM AUTHOR]