CLINICAL ANALYSIS OF MALIGNANT EXTERNAL OTITIS AND SKULL-BASE OSTEOMYELITIS

Abstract

　The diagnostic criteria and treatment strategies for Malignant External Otitis (MEO) and Skull-Base Osteomyelitis (SBO) have not yet been firmly established; therefore, treatment of these diseases remains a challenge in clinical practice. We present 4 cases of MEO and SBO and the results of our analysis of the data of 50 patients who were treated between 1990 and 2015 in Japan. We found that both MEO and SBO are more likely to affect the elderly, and immunodeficient patients, such as those with diabetes mellitus. The mortality rate was as high as 20%, tending to be even higher in patients with paralysis of multiple cranial nerves. In addition, we observed that SBO patients who did not exhibit any signs of inflammation in their external auditory canals were predisposed to recurrences. Thus, we conclude that long-term treatment with antibiotics and follow-up are critical, particularly for those patients who are at a high risk of these diseases.