Head and Neck Pathology

, Volume 12, Issue 3, pp 328–349 | Cite as

Idiopathic, Infectious and Reactive Lesions of the Ear and Temporal Bone

  • Kelly R. Magliocca
  • Esther X. Vivas
  • Christopher C. Griffith
Special Issue: Ear


A number of infectious, inflammatory and idiopathic lesions develop within otologic tissues that may share similar clinical and/or microscopic features. This review first provides a working classification for otitis externa, and then otitis media and includes two recently described entities, eosinophilic otitis media and otitis media with ANCA-associated vasculitis. Next, the microscopic findings of a spectrum of otopathologic conditions are described, including post-inflammatory conditions such as tympanosclerosis and aural polyps, an overview of animate aural foreign body as well as iatrogenic aural foreign body reactions. Finally, a review of fungal disease affecting the ear with a brief synopsis of Candida auris, a recently described and virulent organism, is presented.


Otitis externa Otitis media Aural polyp Tympanosclerosis Otomycosis Myospherulosis 


Compliance with Ethical Standards

Conflict of interest

The authors individually declare no conflicts of interest.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Bojrab DI, Bruderly T, Abdulrazzak Y. Otitis externa. Otolaryngol Clin North Am. 1996;29:761–82.PubMedGoogle Scholar
  2. 2.
    Kesser BW. Assessment and management of chronic otitis externa. Curr Opin Otolaryngol Head Neck Surg. 2011;19:341–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Wipperman J. Otitis externa. Prim Care. 2014;41:1–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Gruber M, Roitman A, Doweck I, et al. Clinical utility of a polymerase chain reaction assay in culture-negative necrotizing otitis externa. Otol Neurotol. 2015;36:733–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Meltzer PE, Kelemen G. Pyocyaneous osteomyelitis of the temporal bone, mandible and zygoma. Laryngoscope. 1959;69:1300–16.CrossRefGoogle Scholar
  6. 6.
    Chandler JR. Malignant external otitis. Laryngoscope. 1968;78:1257–94.CrossRefPubMedGoogle Scholar
  7. 7.
    Evans IT, Richards SH. Malignant (necrotising) otitis externa. J Laryngol Otol. 1973;87:13–20.CrossRefPubMedGoogle Scholar
  8. 8.
    Chawdhary G, Liow N, Democratis J, Whiteside O. Necrotising (malignant) otitis externa in the UK: a growing problem. Review of five cases and analysis of national Hospital Episode Statistics trends. J Laryngol Otol. 2015;129:600–3.CrossRefPubMedGoogle Scholar
  9. 9.
    Goh JPN, Karandikar A, Loke SC, Tan TY. Skull base osteomyelitis secondary to malignant otitis externa mimicking advanced nasopharyngeal cancer: MR imaging features at initial presentation. Am J Otolaryngol. 2017;38:466–71.CrossRefPubMedGoogle Scholar
  10. 10.
    Glikson E, Sagiv D, Wolf M, Shapira Y. Necrotizing otitis externa: diagnosis, treatment, and outcome in a case series. Diagn Microbiol Infect Dis. 2017;87:74–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Franco-Vidal V, Blanchet H, Bebear C, Dutronc H, Darrouzet V. Necrotizing external otitis: a report of 46 cases. Otol Neurotol. 2007;28:771–3.CrossRefPubMedGoogle Scholar
  12. 12.
    Stern Shavit S, Soudry E, Hamzany Y, Nageris B. Malignant external otitis: factors predicting patient outcomes. Am J Otolaryngol. 2016;37:425–30.CrossRefPubMedGoogle Scholar
  13. 13.
    Narozny W, Kuczkowski J, Mikaszewski B. Infectious skull base osteomyelitis–still a life-threatening disease. Otol Neurotol. 2006;27:1047–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Chen CN, Chen YS, Yeh TH, Hsu CJ, Tseng FY. Outcomes of malignant external otitis: survival vs mortality. Acta Otolaryngol. 2010;130:89–94.CrossRefPubMedGoogle Scholar
  15. 15.
    Ostfeld E, Segal M, Czernobilsky B. Malignant external otitis: early histopathologic changes and pathogenic mechanism. Laryngoscope. 1981;91:965–70.CrossRefPubMedGoogle Scholar
  16. 16.
    Bernheim J, Sade J. Histopathology of the soft parts in 50 patients with malignant external otitis. J Laryngol Otol. 1989;103:366–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Mattucci KF, Setzen M, Galantich P. Necrotizing otitis externa occurring concurrently with epidermoid carcinoma. Laryngoscope. 1986;96:264–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Schilder AG, Chonmaitree T, Cripps AW, et al. Otitis media. Nat Rev Dis Primers. 2016;2:16063.CrossRefPubMedGoogle Scholar
  19. 19.
    Van der Poel NA, van Spronsen E, Dietz de Loos DA, Ebbens FA. Early signs and symptoms of intracranial complications of otitis media in pediatric and adult patients: a different presentation? Int J Pediatr Otorhinolaryngol. 2017;102:56–60.CrossRefPubMedGoogle Scholar
  20. 20.
    Bhutta MF, Thornton RB, Kirkham LS, Kerschner JE, Cheeseman MT. Understanding the aetiology and resolution of chronic otitis media from animal and human studies. Dis Model Mech. 2017;10:1289–300.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Schilder AG, Marom T, Bhutta MF, et al. Panel 7: otitis media: treatment and complications. Otolaryngol Head Neck Surg. 2017;156:88–105.CrossRefGoogle Scholar
  22. 22.
    Ferlito A. Pathology of chronic suppurative otitis media. A histological and histochemical study. ORL J Otorhinolaryngol Relat Spec. 1974;36:257–74.CrossRefPubMedGoogle Scholar
  23. 23.
    Salvinelli F, Trivelli M, Greco F, Linthicum FH Jr. Chronic otitis media: histopathological changes: a post mortem study on temporal bones. Eur Rev Med Pharmacol Sci. 1999;3:175–8.PubMedGoogle Scholar
  24. 24.
    Youngs R. The histopathology of mastoidectomy cavities, with particular reference to persistent disease leading to chronic otorrhoea. Clin Otolaryngol Allied Sci. 1992;17:505–10.CrossRefPubMedGoogle Scholar
  25. 25.
    Kamimura M, Balaban CD, Sando I, Ganbo T, Suzuki C. Cellular distribution of mucosa-associated lymphoid tissue with otitis media in children. Ann Otol Rhinol Laryngol. 2000;109:467–72.CrossRefPubMedGoogle Scholar
  26. 26.
    Michal M, Skalova A, Kazakov DVet. al. Mixed epithelial and stromal tumor of the middle ear: the first case report. Hum Pathol. 2017;61:199–204.CrossRefPubMedGoogle Scholar
  27. 27.
    Azadeh B, Dabiri S, Moshfegh I. Malakoplakia of the middle ear. Histopathology. 1991;19:276–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Tomioka S, Kobayashi T, Takasaka T. Intractable otitis media in patients with bronchial asthma (eosinophilic otitis media). In: Sanna M, editor Cholestoma and mastoid surgery. Rome: CIC Edizioni Internazionali 1997; 851–3.Google Scholar
  29. 29.
    Iino Y, Tomioka-Matsutani S, Matsubara A, Nakagawa T, Nonaka M. Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease. Auris Nasus Larynx. 2011;38:456–61.CrossRefPubMedGoogle Scholar
  30. 30.
    Kanazawa H, Yoshida N, Iino Y. New insights into eosinophilic otitis media. Curr Allergy Asthma Rep. 2015;15:76.CrossRefPubMedGoogle Scholar
  31. 31.
    Childers AL, Gruen J, Sayeed S, Powers CN, Coelho DH. Eosinophilic otitis media. Otol Neurotol. 2014;35:e206–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Yang B, Brook CD. The role of allergy in otologic disease. Otolaryngol Clin North Am. 2017;50:1091–101.CrossRefPubMedGoogle Scholar
  33. 33.
    Saliba I, Alzahrani M, Weng X, Bestavros A. Eosinophilic otitis media diagnosis using flow cytometric immunophenotyping. Acta Otolaryngol. 2018;138:110–5.CrossRefPubMedGoogle Scholar
  34. 34.
    Blake DM, Vazquez A, Tomovic S, Jyung RW. Otologic manifestation of Samter triad. Ear Nose Throat J. 2014;93:238–40.PubMedGoogle Scholar
  35. 35.
    Nishizawa H, Matsubara A, Nakagawa T, et al. The role of periostin in eosinophilic otitis media. Acta Otolaryngol. 2012;132:838–44.PubMedGoogle Scholar
  36. 36.
    Nader ME, Bell D, Ginsberg L, DeMonte F, Gunn GB, Gidley PW. The first reported case of primary intestinal-type adenocarcinoma of the middle ear and review of the literature. Otol Neurotol. 2017;38:e364–8.CrossRefPubMedGoogle Scholar
  37. 37.
    Zhu BZ, Bishop JA, Chien WW. A case of allergic fungal otomastoiditis with aural polyps. Otol Case Rep. 2017;2:4–6.Google Scholar
  38. 38.
    Chen CM, Chiang CW. Allergic fungal otomastoiditis: a case report. Laryngoscope. 2013;123:1040–2.CrossRefPubMedGoogle Scholar
  39. 39.
    Mills R, Hathorn I. Aetiology and pathology of otitis media with effusion in adult life. J Laryngol Otol. 2016;130:418–24.CrossRefPubMedGoogle Scholar
  40. 40.
    Azadarmaki R, Westra W, Prasad S. Eosinophilic mucin otomastoiditis and otopolyposis: a progressive form of eosinophilic otitis media. Ann Otol Rhinol Laryngol. 2015;124:752–6.CrossRefPubMedGoogle Scholar
  41. 41.
    Ferguson BJ, Seethala R, Wood WA. Eosinophilic bacterial chronic rhinosinusitis. Laryngoscope. 2007;117:2036–40.CrossRefPubMedGoogle Scholar
  42. 42.
    Okada M, Suemori K, Takagi D, Teraoka M, Yamada H, Hato N. Comparison of localized and systemic otitis media with ANCA-associated vasculitis. Otol Neurotol. 2017;38:e506–10.CrossRefGoogle Scholar
  43. 43.
    Harabuchi Y, Kishibe K, Tateyama K. al. Clinical features and treatment outcomes of otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV): a retrospective analysis of 235 patients from a nationwide survey in Japan. Mod Rheumatol. 2017;27:87–94.CrossRefPubMedGoogle Scholar
  44. 44.
    Hisata Y, Sasaki E, Ishimaru K. al. Do you know otitis media with ANCA-associated vasculitis (OMAAV)? J Gen Fam Med. 2017;18:428–31.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Kukushev G, Kalinova D, Sheytanov I, Rashkov R. Two clinical cases of granulomatosis with polyangiitis with isolated otitis media and mastoiditis. Reumatologia. 2017;55:256–60.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Akyigit A, Yalcin S. Etem EO, et al. Genetic polymorphisms affecting antioxidant enzymes are present in tympanosclerosis patients. J Laryngol Otol. 2016;130:928–33.CrossRefPubMedGoogle Scholar
  47. 47.
    Tukaj C, Kuczkowski J, Sakowicz-Burkiewicz M, et al. Morphological alterations in the tympanic membrane affected by tympanosclerosis: ultrastructural study. Ultrastruct Pathol. 2014;38:69–73.CrossRefPubMedGoogle Scholar
  48. 48.
    Ferlito A. Histopathogenesis of tympanosclerosis. J Laryngol Otol. 1979;93:25–37.CrossRefPubMedGoogle Scholar
  49. 49.
    Branco C, Paco J. Does calcemia influence the onset of myringosclerosis after myringotomy with the insertion of ventilation tubes? Acta Otorrinolaringol Esp. 2017;68:323–7.CrossRefGoogle Scholar
  50. 50.
    Bhaya MH, Schachern PA, Morizono T, Paparella MM. Pathogenesis of tympanosclerosis. Otolaryngol Head Neck Surg. 1993;109:413–20.CrossRefPubMedGoogle Scholar
  51. 51.
    Russell JD, Giles JJ. Tympanosclerosis in the rat tympanic membrane: an experimental study. Laryngoscope. 2002;112:1663–6.CrossRefPubMedGoogle Scholar
  52. 52.
    Makishima K, Toriya Y, Inoue S, Nakashima T, Igarashi Y. Clinicopathologic studies in tympanosclerosis. Am J Otol. 1982;3:260–5.PubMedGoogle Scholar
  53. 53.
    McCadden L, Leonard CG, Primrose WJ. Bisphosphonate-induced osteonecrosis of the ear canal: our experience and a review of the literature. J Laryngol Otol 2018;132:372–4.CrossRefGoogle Scholar
  54. 54.
    Shew M, Bush J, Tawfik O, Ator G. Middle ear aural polyp mimicking glomus tympanicum in a male adolescent. Otol Neurotol 2017;38:e211–3.CrossRefGoogle Scholar
  55. 55.
    Gliklich RE, Cunningham MJ, Eavey RD. The cause of aural polyps in children. Arch Otolaryngol Head Neck Surg. 1993;119:669–71.CrossRefPubMedGoogle Scholar
  56. 56.
    Hussain SS. Histology of aural polyp as a predictor of middle ear disease activity. J Laryngol Otol. 1991;105:268–9.CrossRefPubMedGoogle Scholar
  57. 57.
    Veitch D, Brockbank M, Whittet H. Aural polyps and cholesteatoma. Clin Otolaryngol Allied Sci. 1988;13:395–7.CrossRefPubMedGoogle Scholar
  58. 58.
    Milroy CM, Slack RW, Maw AR, Bradfield JW. Aural polyps as predictors of underlying cholesteatoma. J Clin Pathol. 1989;42:460–5.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Tay HL, Hussain SS. The management of aural polyps. J Laryngol Otol. 1997;111:212–4.CrossRefPubMedGoogle Scholar
  60. 60.
    Spielmann PM, McKean S, White RD, Hussain SS. Surgical management of external auditory canal lesions. J Laryngol Otol. 2013;127:246–51.CrossRefPubMedGoogle Scholar
  61. 61.
    Shen J, Peterson M, Mafee M, Nguyen QT. Aural polyps in Samter’s triad: case report and literature review. Otol Neurotol. 2012;33:774–8.CrossRefPubMedGoogle Scholar
  62. 62.
    Brobst R, Suss N, Joe S, Redleaf S. Bilateral inflammatory aural polyps: a manifestation of Samter’s triad. Int J Otolaryngol 2009:464958.Google Scholar
  63. 63.
    Lara-Sanchez H, Vallejo LA. Eosinophilic otitis media. N Engl J Med. 2017;376:e10.CrossRefPubMedGoogle Scholar
  64. 64.
    Kumar MS, Panella NJ, Magliocca KR, Vivas EX. Otopolyposis with middle ear allergic mucin in a patient with allergic fungal rhinosinusitis. Ann Otol Rhinol Laryngol. 2016;125:862–5.CrossRefPubMedGoogle Scholar
  65. 65.
    Praveen CV, Terry RM, Elmahallawy M, Horsfield C. Pneumocystis carinii infection in bilateral aural polyps in a human immunodeficiency virus-positive patient. J Laryngol Otol. 2002;116:288–90.CrossRefPubMedGoogle Scholar
  66. 66.
    Xenellis J, Mountricha A, Maragoudakis P. al. A histological examination in the cases of initial diagnosis as chronic otitis media with a polypoid mass in the external ear canal. Auris Nasus Larynx. 2011;38:325–8.CrossRefPubMedGoogle Scholar
  67. 67.
    Williams RA, Jackler RK, Corrales CE. Benign temporomandibular joint lesions presenting as masses in the external auditory canal. Otol Neurotol. 2017;38:563–71.CrossRefPubMedGoogle Scholar
  68. 68.
    Indudharan R, Ahamad M, Ho TM, Salim R, Htun YN. Human otoacariasis. Ann Trop Med Parasitol. 1999;93:163–7.CrossRefPubMedGoogle Scholar
  69. 69.
    Jervis-Bardy J, Fitzpatrick N, Masood A, Crossland G, Patel H. Myiasis of the ear: a review with entomological aspects for the otolaryngologist. Ann Otol Rhinol Laryngol. 2015;124:345–50.CrossRefPubMedGoogle Scholar
  70. 70.
    Mathison BA, Pritt BS. Laboratory identification of arthropod ectoparasites. Clin Microbiol Rev. 2014;27:48–67.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    McGraw TA, Turiansky GW. Cutaneous myiasis. J Am Acad Dermatol. 2008;58:907–26. quiz 927 – 909.CrossRefPubMedGoogle Scholar
  72. 72.
    Dana AN. Diagnosis and treatment of tick infestation and tick-borne diseases with cutaneous manifestations. Dermatol Ther. 2009;22:293–326.CrossRefPubMedGoogle Scholar
  73. 73.
    Ariyarathne S, Apanaskevich DA, Amarasinghe PH, Rajakaruna RS. Diversity and distribution of tick species (Acari: Ixodidae) associated with human otoacariasis and socio-ecological risk factors of tick infestations in Sri Lanka. Exp Appl Acarol. 2016;70:99–123.CrossRefPubMedGoogle Scholar
  74. 74.
    Gokdogan O, Cakabay T, Baran H, Karabulut B, Tasdemir C, Vatansever Z. Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal. Braz J Otorhinolaryngol. 2016;82:416–21.CrossRefPubMedGoogle Scholar
  75. 75.
    Matsuo R, Honma M, Komatsu S, Minami-Hori M, Ishida-Yamamoto A, Iizuka H. External ear canal lesions of crusted scabies: a pitfall of recurrence? J Dermatol. 2015;42:1023–4.CrossRefPubMedGoogle Scholar
  76. 76.
    Cevik C, Kaya OA, Akbay E, et al. Investigation of demodex species frequency in patients with a persistent itchy ear canal treated with a local steroid. J Laryngol Otol. 2014;128:698–701.CrossRefPubMedGoogle Scholar
  77. 77.
    Klemm E, Haroske G, Wollina U. Otitis externa and myringitis due to demodicidosis. Acta Dermatovenerol Alp Pannonica Adriat. 2009;18:73–6.PubMedGoogle Scholar
  78. 78.
    Kahn SL, Podjasek JO, Dimitropoulos VA, Brown CW Jr. Excisional debulking and electrosurgery of otophyma and rhinophyma. Dermatol Surg. 2016;42:137–9.CrossRefPubMedGoogle Scholar
  79. 79.
    Villwock JA, Harris TM. Head and neck myiasis, cutaneous malignancy, and infection: a case series and review of the literature. J Emerg Med. 2014;47:e37–41.CrossRefPubMedGoogle Scholar
  80. 80.
    Hatten K, Gulleth Y, Meyer T, Eisenman DJ. Myiasis of the external and middle ear. Ann Otol Rhinol Laryngol. 2010;119:436–8.CrossRefPubMedGoogle Scholar
  81. 81.
    Sharan R, Isser DK. Aural myiasis. J Laryngol Otol. 1978;92:705–8.CrossRefPubMedGoogle Scholar
  82. 82.
    Magliulo G, Gagliardi M, D’Amico R. Human aural myiasis. Otolaryngol Head Neck Surg. 2000;122:777.CrossRefPubMedGoogle Scholar
  83. 83.
    Yuca K, Caksen H, Sakin YFet. al. Aural myiasis in children and literature review. Tohoku J Exp Med. 2005;206:125–30.CrossRefPubMedGoogle Scholar
  84. 84.
    McClatchie S, Warambo MW, Bremner AD. Myospherulosis: a previously unreported disease? Am J Clin Pathol. 1969;51:699–704.CrossRefPubMedGoogle Scholar
  85. 85.
    Phillip V, Becker K, Bajbouj M, Schmid RM. Myospherulosis. Ann Diagn Pathol. 2013;17:383–9.CrossRefPubMedGoogle Scholar
  86. 86.
    Kyriakos M. Myospherulosis of the paranasal sinuses, nose and middle ear. A possible iatrogenic disease. Am J Clin Pathol. 1977;67:118–30.CrossRefPubMedGoogle Scholar
  87. 87.
    Gillespie CA, Clark WB, Finkelstein E, Devaney K. Myospherulosis of the mastoid antrum: a case report. Auris Nasus Larynx. 1990;16:199–207.CrossRefPubMedGoogle Scholar
  88. 88.
    Culviner WT, Leonard DW, Wilhelmsen CL, Bolger WE. Experimental myospherulosis of the paranasal sinuses: a histologic rabbit study. Am J Rhinol. 2000;14:131–7.CrossRefPubMedGoogle Scholar
  89. 89.
    Lin HW, Handzel O, Faquin WC, Gopen Q. Myospherulosis from antibiotic ointment in the postoperative mastoid space. Am J Otolaryngol. 2010;31:205–8.CrossRefPubMedGoogle Scholar
  90. 90.
    Bahmad F Jr, Merchant SN. Histopathology of ossicular grafts and implants in chronic otitis media. Ann Otol Rhinol Laryngol. 2007;116:181–91.CrossRefPubMedPubMedCentralGoogle Scholar
  91. 91.
    Makek M, Mattox DE, Schmid S, Fisch U. Histology of synthetic ossicular prostheses. Arch Otolaryngol Head Neck Surg. 1988;114:1127–30.CrossRefPubMedGoogle Scholar
  92. 92.
    Vennewald I, Klemm E. Otomycosis. Diagnosis and treatment. Clin Dermatol. 2010;28:202–11.CrossRefPubMedGoogle Scholar
  93. 93.
    Satoh K, Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H. Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canal of an inpatient in a Japanese hospital. Microbiol Immunol. 2009;53:41–4.CrossRefPubMedGoogle Scholar
  94. 94.
    Vallabhaneni S, Kallen A, Tsay S. al. Investigation of the first seven reported cases of Candida auris, a globally emerging invasive, multidrug-resistant fungus—United States, May 2013-August 2016. MMWR. 2016;65:1234–7.PubMedGoogle Scholar
  95. 95.
    Vennewald I, Wollina U. Cutaneous infections due to opportunistic molds: uncommon presentations. Clin Dermatol. 2005;23:565–71.CrossRefPubMedGoogle Scholar
  96. 96.
    Vennewald I, Schonlebe J, Klemm E. Mycological and histological investigations in humans with middle ear infections. Mycoses. 2003;46:12–8.CrossRefPubMedGoogle Scholar
  97. 97.
    Song JE, Haberkamp TJ, Patel R, Redleaf MI. Fungal otitis externa as a cause of tympanic membrane perforation: a case series. Ear Nose Throat J. 2014;93:332–6.PubMedGoogle Scholar
  98. 98.
    Menachof MR, Jackler RK. Otogenic skull base osteomyelitis caused by invasive fungal infection. Otolaryngol Head Neck Surg. 1990;102:285–9.CrossRefPubMedGoogle Scholar
  99. 99.
    Chen D, Lalwani AK, House JW, Choo D. Aspergillus mastoiditis in acquired immunodeficiency syndrome. Am J Otol. 1999;20:561–7.PubMedGoogle Scholar
  100. 100.
    Stevens SM, Lambert PR, Baker AB, Meyer TA. Malignant otitis externa: a novel stratification protocol for predicting treatment outcomes. Otol Neurotol. 2015;36:1492–8.CrossRefPubMedGoogle Scholar
  101. 101.
    Bowles PF, Perkins V, Schechter E. Fungal malignant otitis externa. BMJ Case Rep. 2017.Google Scholar
  102. 102.
    Ling SS, Sader C. Fungal malignant otitis externa treated with hyperbaric oxygen. Int J Infect Dis. 2008;12:550–2.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kelly R. Magliocca
    • 1
  • Esther X. Vivas
    • 2
  • Christopher C. Griffith
    • 1
  1. 1.Department of Pathology and Lab MedicineEmory UniversityAtlantaUSA
  2. 2.Department of Otolaryngology - Head & Neck SurgeryEmory UniversityAtlantaUSA

Personalised recommendations