Malignant otitis externa is a condition of persistent severe infection that extends to involve bone and soft tissues of skull base.
-malignant otitis externa affect mainly old ,uncontrolled diabetic patients with low immunity status.
-malignant otitis externa is caused by pseudomonas and Proteus.
- Severe deep seated pain that worse by night.
- Scanty purulent discharge.
- Facial palsy.
- Granulation in the floor of external meatus,producing discharge.
- Tenderness over the floor of external auditory canal.
Local spread to the skull base produce paralysis to facial ,glossopharyngeal,vagus ,accessory,hypoglossal nerves.
- Blood sugar test should be done first
- Culture and sensitivity test.
- CT to temporal bone and skull base.
- Biopsy to detect malignancy.
- PTA to assess hearing.
To treat a case of malignant otitis externa you should first control the blood glucose levels.
-Give antibiotics for at least 6 weeks.
-For local treatment give antibiotics together with aural toilet.
-Surgical intervention in malignant otitis externa is done to only remove dead bone.