A Case Series of Malignant Otitis Externa Mimicking Malignancy

Abstract

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

The diagnostic conundrum in necrotizing otitis externa

“…However, NOE is a notoriously challenging diagnosis to make due to the inconsistencies with diagnostic investigations 12 . In addition, its clinical picture and complications can mimic nasopharyngeal and other EAC malignancies as well as cholesteatoma and persistent otitis externa 13,14 . It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease.…”

“…12 In addition, its clinical picture and complications can mimic nasopharyngeal and other EAC malignancies as well as cholesteatoma and persistent otitis externa. 13,14 It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease. This narrative review aims to evaluate the different diagnostic options available in NOE (specifically otogenic skull base osteomyelitis from an otitis externa) and discuss their advantages and limitations.…”