Malignant otitis externa

Definition:-

Malignant otitis externa is a condition of persistent severe infection that extends to involve bone and soft tissues of skull base.

About disease:-

-malignant otitis externa affect mainly old ,uncontrolled diabetic patients with low immunity status.

-malignant otitis externa is caused by pseudomonas and Proteus.

Symptoms:

  1. Severe deep seated pain that worse by night.
  2. Scanty purulent discharge.
  3. Facial palsy.

Signs:

  1. Granulation in the floor of external meatus,producing discharge.
  2. Tenderness over the floor of external auditory canal.

Complications

Local spread to the skull base produce paralysis to facial ,glossopharyngeal,vagus ,accessory,hypoglossal nerves.

Investigations:

  1. Blood sugar test should be done first
  2. Culture and sensitivity test.
  3. CT to temporal bone and skull base.
  4. Biopsy to detect malignancy.
  5. PTA to assess hearing.

Treatment:-

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.


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Category | ENT
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