Malignant otitis externa with skull base osteomyelitis

Abstract

Malignant otitis externa associated with skull base osteomyelitis is a condition seen classically in the elderly, diabetic patient. This disease is difficult to manage, often requiring long-term antibiotic therapy. Here we present such a case, seen in a 74- year-old lady. Initially, she was treated for a number of years in the outpatient department with intermittent ear complaints, but eventually required a hospital admission that lasted for 6 months due to a severe malignant otitis externa complicated by skull base osteomyelitis. We will discuss the clinical features, diagnostic criteria, imaging and management of this life-threatening clinical entity.

Necrotizing Otitis Externa: A Disease Barely Known to Neurosurgeons

“…As previously shown, there is no pathognomonic criterion for the diagnosis of NOE or of its complications, such as SBO. 4,17,18 The insidious progression and difficult diagnosis delay treatment, which can lead to complications and even death. 4,5,8,9 As such, we propose a flowchart, which is currently adopted in our institution and is based on the scientific literature used to prepare the present paper (►Fig.…”

Imaging of the Skull Base

“…This condition has been called malignant otitis because of its mortality and poor response to treatment. 12 Evaluation with imaging typically initiates with CT. However, initially soft tissue inflammation is the only finding, associated with mastoid effusion because 30% of the affected bone needs to be demineralized to appear eroded on CT. 13 MR imaging better shows the soft tissue abnormality.…”

Malignant externa otitis: the modern principles of diagnostics and treatment

“…В настоящее время не существует единой тактики и принципов хирургического лечения ЗНО. Большинство авторов ввиду высокого риска распространения инфекции на интактные участки кости проведение хирургического вмешательства не рекомендуют [4,5]. Декомпрессия лицевого нерва также не показана, так как она не влияет на восстановление его функции.…”