Skip to main content

Advertisement

Log in

Computed tomography and magnetic resonance imaging findings before and after treatment of patients with malignant external otitis

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The aim of our prospective study is to illustrate the role of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis and delineation of the extent of disease in malignant external otitis (MEO) at presentation and following successful treatment. The study was performed at Tertiary academic referral center. We included 18 patients (16 males and 2 females; age, 49–79 years; mean, 65.3 years) with a clinical diagnosis of MEO in this study. CT and MRI were performed at presentation. Follow-up CT and MRI were performed after 6 and 12 months in 12 successfully treated patients. The main outcomes are CT scan and MRI findings. Results show that all patients were known to have diabetes mellitus. We present the patients’ demographic and clinical data. All patients received local treatment as well as the intravenous 3rd generation antibiotic cephalosporin for at least 6 weeks. The detailed radiological findings were reported. In conclusion, MEO is predominantly a disease of diabetic males and MEO can be managed by the control of diabetes, local treatment, and intravenous antibiotics for a long period. CT and MRI play complementary roles in the diagnosis and follow-up of patients with MEO. The extension of the disease before treatment and its disappearance from the involved areas are usually characteristic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10

Similar content being viewed by others

References

  1. Grandis RJ, Branstetter BF, Yu VL (2004) The changing face of malignant (necrotizing) external otitis: clinical, radiological and anatomic correlation. Lancet Infect Dis 4:34–39

    Article  Google Scholar 

  2. Chandler J (1968) Malignant external otitis. Laryngoscope 78:1257

    Article  PubMed  CAS  Google Scholar 

  3. Hariga I, Mardassi A, Belhaj Younes F et al (2010) Necrotizing otitis externa: 19 cases’ report. Eur Arch Otorhinolaryngol 267:1193–1198

    Article  PubMed  Google Scholar 

  4. Handzel O, Halperin D (2003) Necrotizing (malignant) external otitis. Am Fam Physician 68:309–312

    PubMed  Google Scholar 

  5. Carfrae MJ, Kesser BW (2008) Malignant otitis externa. Otolaryngol Clin North Am 41:537–549

    Article  PubMed  Google Scholar 

  6. Sreepada GS, Kwartler JA (2003) Skull base osteomyelitis secondary to malignant otitis externa. Curr Opin Otolaryngol Head Neck Surg 11:316–323

    Article  PubMed  Google Scholar 

  7. Arnold R, Baylin G (1959) Destructive lesions of the temporal bone. Laryngoscope 69(6):766–788

    Article  PubMed  CAS  Google Scholar 

  8. Nadol JB (1980) Histopathology of pseudomonas osteomyelitis of the temporal bone starting as malignant external otitis. Am J Otolaryngol 1:359–371

    Article  PubMed  Google Scholar 

  9. Kohut RI, Lindsay JR (1979) Necrotizing (“malignant”) external otitis: histopathologic processes. Ann Otol Rhinol Laryngol 88:714–720

    PubMed  CAS  Google Scholar 

  10. Amorosa L, Modugno GC, Pirodda A (1996) Malignant external otitis: review and personal experience. Acta Otolaryngol Suppl 521:3–16

    PubMed  CAS  Google Scholar 

  11. Soudry E, Joshua BZ, Sulkes J, Nageris BI (2007) Characteristics and prognosis of malignant external otitis with facial paralysis. Arch Otolaryngol Head Neck Surg 133(10):1002–1004

    Article  PubMed  Google Scholar 

  12. Joshua BZ, Sulkes J, Raveh E, Bishara J, Nageris BI (2008) Predicting outcome of malignant external otitis. Otol Neurotol 29:339–343

    Article  PubMed  Google Scholar 

  13. Mani N, Sudhoff H, Rajagopal S, Moffat D, Axon PR (2007) Cranial nerve involvement in malignant external otitis: implications for clinical outcome. Laryngoscope 117(5):907–910

    Article  PubMed  Google Scholar 

  14. Ali T, Meade K, Anari S, ElBadawey MR, Zammit-Maempel I (2010) Malignant otitis externa: case series. J Laryngol Otol 124:846–851

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have neither conflict of interest nor financial relationship with the organization that sponsored the research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khaled Al-Noury.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Al-Noury, K., Lotfy, A. Computed tomography and magnetic resonance imaging findings before and after treatment of patients with malignant external otitis. Eur Arch Otorhinolaryngol 268, 1727–1734 (2011). https://doi.org/10.1007/s00405-011-1552-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-011-1552-8

Keywords

Navigation