Malignant otitis externa (MOE) is a rare and potentially life-threatening infection of the external ear canal and adjacent soft tissue that occurs primarily in immunocompromised individuals. The infection spreads from the external ear canal to the adjacent temporal bone and skull base.
Facial nerve palsy is a known complication of MOE, and it occurs due to the involvement of the facial nerve in the temporal bone. The facial nerve runs through a narrow bony canal called the facial canal, which is located in close proximity to the middle ear cavity. In MOE, the infection can spread to the facial canal and cause inflammation and destruction of the bone surrounding the facial nerve. This inflammation and destruction of the bone can compress the facial nerve and lead to facial nerve palsy.
The severity of facial nerve palsy in MOE can range from mild weakness to complete paralysis, depending on the degree of inflammation and destruction of the facial nerve. In some cases, the facial nerve palsy may be the first presenting symptom of MOE.
Treatment for MOE usually involves long-term antibiotic therapy and sometimes surgery to remove infected tissue or relieve pressure on the facial nerve. If left untreated, MOE can lead to serious complications such as skull base osteomyelitis and meningitis.