Malignant otitis externa


“Malignant” otitis externa is
a rare and serious form of otitis externa
to which elderly diabetics are particularly
susceptible. Granulation tissue is
found in the meatus infected with
Pseudomonas and anaerobic organisms.
This granulation tissue tends to erode
deeply, involving the middle and inner
ear, the bone of the skull base with
extension to the brain, and also the
great vessels of the neck. If uncontrolled,
the condition may be fatal.
Intense antibiotic therapy sometimes
associated with surgical drainage
of the affected areas is necessary. It is
not a “malignant” condition in the histological
sense, for the biopsies of granulation
tissue show inflammatory
changes only. “Necrotizing” otitis externa
may be more accurate, but “malignant”
indicates the serious clinical
nature.

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