Abstract
I report 2 cases of external auditory canal necrosis characterized by otorrhea, bone necrosis, and pain-free pseudomonas infection. The 52-year-old man and 76-year-old woman had no diabetes mellitus. Findings in common included bone necrosis, tissue debris granulation tissue, and bone exposed due to slow progressive destruction of the external auditory canal.
Local culture showed pseudomonas infection without keratin debris.
Differential diagnosis included malignant external otitis, benign necrotizing otitis, cholesteatoma of the external auditory canal, keratosis obturans, malignant tumors, and radiation necrosis.
I concluded that chronic bone destruction was due to pseudomonas infection of the ear expanding into the external auditory canal over the long disease process.
My 2 cases differed clinically from diseases cited in differential diagnosis, and we propose that this condition be termed destructive otitis externa.
I also propose that cholesteatoma of the external auditory canal be classified from keratosis obturans due to their different pathologies
