2021 Volume 114 Issue 7 Pages 507-514
Malignant external otitis is a serious and potentially life-threatening condition, that occurs almost exclusively in the elderly, diabetic patients, and immunocompromised hosts. The infection begins in the external auditory canal and spreads progressively along the soft tissues and bone of the skull base, resulting in cranial nerve palsies and osteomyelitis.
We present our experience with seven patients diagnosed as having malignant external otitis. All patients complained of severe ear pain or headache that became worse at nights. Four patients developed cranial nerve palsies and three developed skull base osteomyelitis.
All the patients received long-term antibacterial or antifungal therapy. Five patients underwent surgical debridement and one was well controlled with hyperbaric oxygen therapy (HBO). Two of the seven patients died of malignant external otitis and none of the patients developed recurrence.
We consider that severe earache or headache that worsens at night is one of the most important clues to the diagnosis of malignant external otitis. Based on our review, we would recommend surgical debridement and HBO in addition to antibiotic therapy for treatment. Long-term follow up is necessary for preventing recurrence.
