Abstract
Two cases which are considered to be typical examples of malignant otitis externa are herein reported. Both cases were elderly individuals who had untreated diabetes militus. Their chief complaints were severe otalgia caused by Pseudomonas aerginosa. Furthermore, they also suffered from palsy nerves vagus. One case recovered while the other did not. We first treated them as out-patients but they did not improve. As a result, both were hospitalized. The blood sugar levels of both patients were controlled and antibiotics was administered. In addition, a radical operation of the middle ear was performed and the external ear canal was also carefully washed. We also applied insulin locally to the external ear canal in the second case. As a result of controlling the blood sugar levels, their CRP levels decreased. Thereafter, their symptoms gradually improved. CT, MRI and RI effectively showed the extent of disease but did no help in the prognosis or in predicting the disease outcome. Careful examinations of the CRP levels were most helpful in following the course of the disease.
