抄録
Malignant external otitis is an invasive infection of the external auditory canal mostly caused by Pseudomonous aeruginosa. The syndrome mainly affects elderly patients with diabetes mellitus. Though the patients were usually cured with conservative treatment using antibiotics, we present herein two cases of malignant external otitis in whom otological surgery was performed.
Case 1 was a 35-year-old male with diabetes mellitus type 1. He was referred to our hospital after having been treated for several months with oral antibiotics for the left ear pain and discharge. On examination, the ear canal was severely edematous and erythematous. Cultures of aural drainage demonstrated P. aeruginosa and high-resolution computed tomography (HRCT) showed defects in the external auditory canal. Malignant external otitis was diagnosed, and the patient was treated with cefozopran. Because the patient suffered from ear discharge despite the treatment, surgery was eventually performed. His postoperative course was satisfactory and there is no sign of recurrence.
Case 2 was a 63-year-old male with diabetes mellitus type 2. He was admitted after having been treated for 2 months with oral antibiotics for the swelling around the right temporomandibular joint and right ear pain and discharge. On examination, the ear canal was edematous and the retraction pocket on the Pars flaccida of the tympanic membrane was filled with keratinized debris. Cultures demonstrated P. aeruginosa. HRCT showed defects of the temporomandibular joint and the attic and tympanic cavity were filled with soft tissue. Malignant external otitis caused by cholesteatoma was diagnosed, and tympanoplasty with mastoidectomy was performed. The patient improved immediately and shows no sign of recurrence.
