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Diagnosis - Malignant Otitis Externa

This condition is distinctly different from the run-of-the mill, garden variety otitis externa. In fact, otitis externa is a rather rare and at times life-threatening disease that can be easily misdiagnosed in the emergency department.

These patients present with ear pain that far exceeds the pain of usual otitis externa. In addition, purulent drainage is a hallmark of this disorder. As with this patient, more than 80 percent of patients will have some degree of immunocompromise, including diabetes mellitus. In addition, these patients will often have findings of osteomyelitis of the base of the skull, mastoid, or external auditory canal on computerized tomography. Often cranial…

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 Malignant Otitis Externa: Diagnosis and Treatment

Otitis externa, colloquially known as swimmers ear or tropical ear, is an infection of the external auditory canal (Figure 1). In the elderly, diabetics, AIDS patients, and the immunocompromised it may progress to Malignant Otitis Externa (MOE). Also known as Necrotizing External Otitis, it is an aggressive form of OE. Prognosis has improved with antibiotics but MOE still has a high rate of mortality1.

Articles of Interest

Changing Trends in the Management of Malignant Otitis Externa: Our Experience

Malignant otitis externa is a serious invasive disease affecting mainly the elderly diabetic patients and other immune-compromised people. The most common presentation is severe otolgia with otorrohea followed by facial nerve palsy and in most of the cases symptoms are out of proportion to clinical signs. Pseudomonas aeruginosa is the most common organism isolated and is usually water borne.

Hyperbaric oxygen as an additional treatment for malignant otitis externa

No clear evidence exists to demonstrate the efficacy of hyperbaric oxygen therapy when compared to treatment with antibiotics and/or surgery. We found no data to compare rates of complication between the different treatment modalities. Further research is required.

Malignant Otitis Externa – Clinical presentation, Diagnosis and Treatment

Though this is not a neoplastic disease, it’s named so because of the high morbidity associated. The disease is also known as skull base osteomyelitis or necrotizing otitis externa.

Malignant otitis externa: An emerging scourge

Malignant otitis externa is an emerging problem in developing countries. We are seeing an increase in this condition in elderly people with diabetes.

Necrotizing (“Malignant”) Otitis Externa

Necrotizing (“malignant”) otitis externa (NOE) is a spreading necrotizing infection of the external auditory canal (EAC) soft tissue that can produce an osteomyelitis of the entire skull base. It is most commonly caused by pseudomonas but is also less commonly caused by Staphylococcus aureus and Proteus mirabilis. Aspergillus may also be a causative agent.

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StatPearls

Malignant otitis externa, although it is not a malignancy, it behaves and spreads like one, hence the name. The first case of MOE was reported in 1938, and the term ‘malignant otitis externa’ was described later by Chandler in 1968, due to its high fatality rate in that time.

WikEM

Life-threatening infection of external ear/canal, soft tissue, +/- spread to skull base. Diabetes and immunosuppression are main risk factors.