193 results match your criteria External Ear Malignant External Otitis

Necrotising otitis externa: a serious condition becoming more frequently encountered.

J Laryngol Otol 2021 Nov 25:1-5. Epub 2021 Nov 25.

ENT Department, Barking Havering and Redbridge University Hospitals, London, UK.

Background: Necrotising otitis externa is an aggressive infection of the external ear, which extends to the surrounding bone and soft tissue. In recent years, there has been an apparent increase in the number of patients admitted to our hospital with this condition.

Methods: A retrospective review was conducted of all patients admitted to our hospital with necrotising otitis externa between July 2012 and June 2020. Read More

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November 2021

Malignant external otitis by Aspergillus flavus.

Enferm Infecc Microbiol Clin (Engl Ed) 2021 Aug-Sep;39(7):358-359

Infectious Diseases Department, Ramon y Cajal University Hospital, Madrid, Spain. Electronic address:

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October 2021

Diabetes and glycemic control in necrotizing otitis externa (NOE).

Eur Arch Otorhinolaryngol 2022 Mar 1;279(3):1269-1275. Epub 2021 Apr 1.

Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben Gurion University, Yitzhak I. Rager Blvd 151, 84101, Beer Sheva, Israel.

Purpose: Although the association between necrotizing otitis externa (NOE) and diabetes mellitus (DM) is well known, there is little knowledge in regards to the effects of DM and glycemic control on the outcome of NOE. The aim of the study was to determine the effects of DM duration and glycemic control, and in-hospital glycemic control on NOE severity.

Methods: A retrospective case series analysis, including all patients hospitalized between 1990 and 2018 due to NOE were included. Read More

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Computer tomography findings in necrotizing otitis externa based on the offending pathogens.

Eur Arch Otorhinolaryngol 2021 Dec 27;278(12):4707-4713. Epub 2021 Jan 27.

Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University in the Negev, Beersheba, Israel.

Purpose: High-resolution temporal bone computer tomography (HRTBCT) is the most common initial radiological modality used for the assessment of necrotizing otitis externa (NOE).

Objectives: (1) To compare the extension of disease, as seen on HRTBCT, in patients with NOE caused by different pathogens and (2) assess whether radiological findings may suggest the offending pathogen in cases of sterile-NOE.

Methods: All NOE patients were hospitalized between 1990 and 2018. Read More

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December 2021

Multiple cranial nerve palsies in malignant external otitis: A rare presentation of a rare condition.

IDCases 2020 5;22:e00945. Epub 2020 Sep 5.

Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Department of Otorhinolaryngology, Marques do Parana Street, 303. Niterói, Rio de Janeiro, Brazil.

Malignant external otitis (MEO) is a rare inflammatory and infectious condition, typically caused by , that mainly affects diabetic or immunocompromised elderly patients and is associated with severe morbidity and mortality. It begins in the external auditory canal and rapidly progresses through the skull base, leading to osteomyelitis and may result in cranial neuropathy, especially of the facial nerve. Here we describe a rare neurological presentation of MEO in a 65-year old diabetic man, who presented with an 8-month progressing left otitis externa and evolved with ipsilateral proptosis, ophthalmoplegia, blindness, facial palsy, hearing loss and contralateral evolvement of the temporal bone with hearing impairment. Read More

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September 2020

Malignant Otitis External: Our Experience and Literature Review.

Am J Case Rep 2020 Aug 18;21:e925060. Epub 2020 Aug 18.

Department of Neuroscience, Reproductive and Odontostomatological Sciences, Otorhinolaryngology - Head and Neck Surgery Unit, University of Naples Federico II, Naples, Italy.

BACKGROUND Malignant external otitis (MEO) is an invasive infection that can involve the external auditory canal and the skull base up to the contiguous soft tissues. Considering the changing face of MEO, we reviewed cases of MEO treated in our Ear Nose Throat (ENT) clinic - University Federico II of Naples between 2018 and 2019 to evaluate the current epidemiology of the condition and to assess the state of art on diagnosis, therapeutic and follow-up management in our patients. CASE REPORT We present the cases of three male patients with Type 2 diabetes mellitus who complained of long-lasting otorrhea and pain, with clinical suspicion of MEO. Read More

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C1/C2 osteomyelitis secondary to malignant otitis externa complicated by atlantoaxial subluxation-a case report and review of the literature.

AME Case Rep 2020 30;4:19. Epub 2020 Jul 30.

Department of Orthopaedic Surgery, Ng Teng Fong Hospital, Singapore, Singapore.

We present a case of C1/C2 osteomyelitis secondary to malignant otitis externa complicated by atlantoaxial subluxation. This case is unique because surgical fixation of the spine was delayed, and despite clearance of the infection with antibiotics, the patient developed cervical myelopathy and required instrumented spinal fusion surgery. He presented with 1 month of fever, headache and worsening neck stiffness. Read More

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An emergency medicine-focused review of malignant otitis externa.

Am J Emerg Med 2020 08 29;38(8):1671-1678. Epub 2020 Apr 29.

Brooke Army Medical Center, Department of Emergency Medicine, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.

Introduction: Malignant otitis externa (MOE) is a progressive infection of the external auditory canal (EAC). This disease is rare but has severe morbidity and mortality.

Objective: This narrative review provides an overview of malignant otitis externa for emergency clinicians. Read More

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Malignant Otitis Externa: Causes for Various Treatment Responses.

J Int Adv Otol 2020 Apr;16(1):98-103

Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.

Objectives: Malignant (necrotizing) otitis externa (MOE) is an aggressive form of skin inflammation of the external ear with a tendency to spread infection to the temporal bone. The study aimed to evaluate a causal relationship between treatment responses and clinical features in patients with MOE.

Materials And Methods: In a retrospective, descriptive section study, the database was analyzed between January 2008 and December 2018 in our department, all patients with diagnosed MOE were identified. Read More

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Surgery for necrotizing otitis externa-indications and surgical findings.

Eur Arch Otorhinolaryngol 2020 May 12;277(5):1327-1334. Epub 2020 Feb 12.

Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Yitzhak I. Rager Blvd 151, 84101, Beer-Sheva, Israel.

Purpose: Treatment for necrotizing otitis externa (NOE) includes long term antibiotic and surgery in selected cases. Indications and extent of surgery, however, are still not defined. The aims of this study were: (1) present our experience in surgery for NOE (2) compare high-resolution computer tomography and perioperative findings (3) suggest recommendations for indications and extent of surgery. Read More

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Thirty-Day Readmission and Prolonged Length of Stay in Malignant Otitis Externa.

Laryngoscope 2020 09 22;130(9):2220-2228. Epub 2019 Nov 22.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Objectives: To determine independent risk factors for 30-day readmission, prolonged length of stay (PLOS), and discharge to a rehabilitation facility for those with malignant otitis externa.

Methods: Retrospective cohort study of patients hospitalized with malignant otitis externa (International Classification of Diseases, 9th edition, code 380.14) in the Nationwide Readmissions Database (2013-2014). Read More

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September 2020

A retrospective review of 14 cases of malignant otitis externa.

J Otol 2019 Jun 8;14(2):63-66. Epub 2019 Jan 8.

Department of Otorhinolaryngology, K.S.Hegde Medical Academy, Nitte(deemed to be University), Mangalore, Karnataka, India.

Background: Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base. It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients. We reviewed cases of malignant otitis externa in our setup to document the epidemiology and outcome of management. Read More

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Malignant (necrotizing) externa otitis: the experience of a single hyperbaric centre.

Eur Arch Otorhinolaryngol 2019 Jul 4;276(7):1881-1887. Epub 2019 Jun 4.

Centro de Medicina Subaquática e Hiperbárica de Lisboa, Lisbon, Portugal.

Introduction: Malignant otitis externa (MOE) is a potentially life-threatening infection of the soft tissues of the external ear, quickly spreading to involve the periosteum and bone of the skull base. Treatment includes antibiotics and eventually surgery. Hyperbaric oxygen treatment (HBOT) has been proposed as an adjunctive therapy. Read More

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Otitis Externa.

Dtsch Arztebl Int 2019 03;116(13):224-234

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Leipzig; Department of Pediatrics, University Hospital Carl Gustav Carus Dresden, TU Dresden; Institute of General Practice, Technical University of Munich; HNO-Praxis Lundershausen, Erfurt.

Background: Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.

Methods: This review is based on publications retrieved by a selective search of the pertinent literature.

Results: The treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Read More

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[Atypical skull base osteomyelitis suspected of spreading inflammation from the ear canal with unilateral multiple cranial neuropathy and cerebral infarctions].

Rinsho Shinkeigaku 2019 Apr 30;59(4):205-210. Epub 2019 Mar 30.

Department of Neurology, Japan Community Healthcare Organization Kyushu Hospital.

A 76-year-old man, who had undergone surgery for esophageal cancer in 2010, presented to our hospital in April 2017 complaining of prolonged slight fever, loss of appetite, and dysphagia. Initial evaluation revealed a paralyzed left vocal cord, slight muscle weakness of the extremities, left facial paralysis, hoarseness, left sternocleidomastoid and trapezius muscle weakness, tongue deviation to the left, and left hypacusia-suggesting a diagnosis of Garcin's syndrome. Laboratory tests revealed increased white blood cells and C-reactive protein. Read More

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The Impact of using the term "Diabetic Ear" for the patients with Skull Base Osteomyelitis.

J Family Community Med 2019 Jan-Apr;26(1):23-29

Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, KFUH, Al-Khobar, Saudi Arabia.

Background: Diabetes and ear disease are some of the most widespread health concerns. The focus here is on the impact of using the term "Diabetic Ear" for patients with skull base osteomyelitis (SBM) in the context of malignant otitis externa (MOE). The aim of this study was to discover the awareness of general practitioners (GPs), residents, specialists, and consultants at Primary Health Care Centers about necrotizing otitis externa (NOE), also known previously as malignant external otitis (MOE), assess their deficiencies and provide solutions; also assist them for the early detection and possible prevention of diabetes- related ear diseases and their complications. Read More

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January 2019

FDG-PET/CT for diagnosis and follow-up of necrotizing (malignant) external otitis.

Laryngoscope 2019 04 14;129(4):961-966. Epub 2018 Dec 14.

Department of Otolaryngology-Head and Neck Surgery, Petach Tikva, Israel.

Objective: Imaging is important for the diagnosis and follow-up of necrotizing external otitis (NEO). The best imaging modality is controversy. To suggest 2-deoxy-2-[fluorine-18] fluoro-D-glucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) as an alternative to technetium-99m and gallium-67 scans for diagnosis and assessment of response to treatment for patients with NEO. Read More

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The Role of Surgical Debridement in Cases of Refractory Malignant Otitis Externa.

Indian J Otolaryngol Head Neck Surg 2018 Dec 18;70(4):549-554. Epub 2018 Jun 18.

Sri Guru Ram Das Institute of Health Sciences and Research Amritsar, 27-C; Sant Avenue, The Mall, Amritsar, 143001 India.

Malignant Otitis externa is a necrotizing condition of external ear involving causing the osteomyelitis of the bone and surrounding soft tissue leading to multiple cranial nerve palsies. Though most patients respond to oral ciprofloxacin but due to emerging resistance cases of refractory malignant otitis externa which are unresponsive to antibiotic therapy for at least 6 weeks are being encountered lately. A study of 20 patients of refractory malignant otitis Externa was conducted at a tertiary care centre in north India; 10 patients were randomly allotted in group A and group B each. Read More

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December 2018

Diagnosis and treatment of necrotising otitis externa and diabetic foot osteomyelitis - similarities and differences.

J Laryngol Otol 2018 Sep 28;132(9):775-779. Epub 2018 Aug 28.

Department of Otolaryngology - Head and Neck Surgery,Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University in the Negev,Beer-Sheva,Israel.

Objective: Necrotising otitis externa is a severe inflammatory process affecting soft tissue and bone, mostly in diabetic patients. Diabetic patients are also at risk of diabetic foot osteomyelitis, another inflammatory condition involving soft tissue and bone. This review aimed to describe the similarities and differences of these entities in an attempt to further advance the management of necrotising otitis externa. Read More

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September 2018

Malignant external otitis following radiotherapy for oral cancer: A case report.

Medicine (Baltimore) 2018 May;97(21):e10898

Department of Oral and Maxillofacial Surgery Department of Otorhinolaryngology, Toshiba Rinkan Hospital, Sagamihara Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan.

Rationale: Although an ototoxicity is well-known as adverse event of the radiotherapy, it is not widely known that immunosuppressed patients who underwent radiotherapy in head and neck region have risk of malignant external otitis.

Patient Concerns: A 68-year-old man with diabetes, who had been diagnosed as intraosseous squamous cell carcinoma of the right mandible, underwent surgical resection. He received a total of 60 Gy/30Fr postoperative radiation. Read More

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[The tumors of the ear].

Presse Med 2017 Nov 31;46(11):1079-1088. Epub 2017 Oct 31.

Hôpital Robert-Debré, departement d'oto-rhino-laryngologie, 51100 Reims, France; Université de Reims Champagne-Ardenne, faculté de médecine, 51100 Reims, France.

Any cutaneous lesion of the outer ear must be managed jointly by a dermatologist and an ENT, regardless of the age of the patient. The presence of a malignant cutaneous carcinoma (Squamous cell carcinoma or melanoma) of the pavilion requires a minimum extension assessment by a cervical ultrasound, CT-scan and MRI will be prescribed according to the degree of infiltration and the presence of clinics signs (lymphadenopathy, facial paralysis, cognitive impairment). A polyp of the external auditory meatus must be systematically biopsied in consultation and, if necessary, in the operating room with fresh anatomopathological analysis. Read More

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November 2017

The treatment of pseudoaneurysms with flow diverters after malignant otitis externa.

Interv Neuroradiol 2017 Dec 9;23(6):609-613. Epub 2017 Oct 9.

4 Department of Radiology, Faculty of Medicine, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.

Background We report a case of bilateral malignant otitis externa complicated with bilateral petrous internal carotid artery pseudoaneurysms and their successful treatment with a flow diverter. Case report A 68-year-old woman with serious complications of type II diabetes mellitus had malignant otitis externa on the right side. She was treated with combined antibiotic therapy and underwent mastoidectomy for mastoiditis. Read More

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December 2017

[External auditory canal cholesteatoma].

Pan Afr Med J 2016 27;24:269. Epub 2016 Jul 27.

Service d'Oto-rhino-laryngologie et Chirurgie Cervico-Faciale, CHU Mohammed VI, Oujda, Maroc.

External auditory canal cholesteatoma is defined as an accumulation of keratin leading to osteolytic bony erosion. It is a rare or underdiagnosed otologic entity. Our study aims to illustrate one case of external auditory canal cholesteatoma. Read More

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Invasive keratinizing squamous cell carcinoma of the left external auricular canal and the middle ear - case report.

Rom J Morphol Embryol 2017 ;58(4):1519-1524

Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, "Titu Maiorescu" University, Bucharest, Romania; Department of Anatomy, Faculty of Dental Medicine, "Ovidius" University of Constanta, Romania;

The rather low incidence of auricular neoplasms irrespective of localization is likely to cause confusion of diagnosis with the more frequent benign ear pathology. Because of this, the elapsed time until confirmation of the diagnosis facilitates the evolution of the disease to the detriment of the patient's health. The diagnosis of an ear neoplasm can hide under the ordinary appearance of external otitis, chronic otorrhea or episodes of various types of ear pain. Read More

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September 2018

Propionibacterium skull base osteomyelitis complicated by internal carotid artery pseudoaneurysm.

Laryngoscope 2017 10 15;127(10):2337-2339. Epub 2016 Nov 15.

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A.

The microbiology of skull base osteomyelitis (SBO) is evolving. We present here the first case of SBO caused by Propionibacterium acnes leading to the development of a pseudoaneurysm of the internal carotid artery. Otolaryngologists should recognize this pathogen as a potential cause of invasive temporal bone infection to optimize prompt diagnosis and treatment. Read More

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October 2017

Scedosporium apiospermum: a rare cause of malignant otitis externa.

BMJ Case Rep 2016 Sep 9;2016. Epub 2016 Sep 9.

Department of ENT, South Devon NHS Foundation Trust, Torquay, Devon, UK.

A 79-year-old man, with a history of well-controlled diabetes mellitus, presented with left-sided otalgia. With an initial diagnosis of simple otitis externa, he was discharged on topical drops. He represented 2 months later with worsening otalgia and discharge. Read More

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September 2016

Malignant external otitis: Factors predicting patient outcomes.

Am J Otolaryngol 2016 Sep-Oct;37(5):425-30. Epub 2016 May 6.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Otolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel. Electronic address:

Objective: Malignant external otitis (MEO) is an aggressive infection, primarily affecting elderly diabetic patients. It begins in the external ear canal and spreads to adjacent structures. This study investigated the clinical characteristics of patients diagnosed and treated for MEO and analyzed factors affecting patient outcomes. Read More

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Malignant external otitis in Spain.

Acta Otorrinolaringol Esp 2017 Jan - Feb;68(1):23-28. Epub 2016 May 27.

Servicio de Otorrinolaringología Hospital Universitario de La Ribera, Alzira, Valencia, España.

Introduction: Malignant external otitis is a necrotizing infection, which extends from the squamous epithelium of the ear canal to the adjacent tissue. The objective of the study was to investigate its incidence and other epidemiological data in Spain, reporting the largest case series to date.

Methods: A descriptive, retrospective study of the Spanish population was carried out using the minimum basic data set (MBDS) based on data of patients admitted to hospitals in the 2008-2013 period. Read More

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February 2018

Malignant Otitis Externa and Stroke.

Eur J Case Rep Intern Med 2016 14;3(4):000387. Epub 2016 Apr 14.

Department of Internal Medicine, Hospital de Egas Moniz, Lisboa, Portugal.

Malignant otitis externa (MOE) is an aggressive but benign entity which evolves into skull base osteomyelitis. An 81-year-old female patient was admitted for left hemiparesis and homonymous hemianopia. She complained of headache radiating to the right cervical area. Read More

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Hypoglossal paresis as the only complication of malignant otitis externa.

B-ENT 2015 ;11(3):235-8

Background: Ipsilateral hypoglossal nerve (XII) paresis has never been reported as the first and only complication of malignant otitis external (MOE).

Case Report: A 73-year-old diabetic male with persistent left temporomandibular joint ache and ear fullness was admitted with the diagnosis of MOE. He received intravenous ciprofloxacin for 14 days and then continued with oral administration (per os). Read More

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January 2016