Malignant otitis externa (MOE), also known as skull base osteomyelitis, is a severe and potentially life-threatening infection that affects the external ear canal and surrounding tissues, extending to involve the base of the skull. It typically occurs in older adults, especially those with diabetes or compromised immune systems.
MOE usually begins as a localized infection of the external ear canal, often due to bacteria such as Pseudomonas aeruginosa. If left untreated or inadequately treated, the infection can spread to nearby structures, including the bones of the skull base, leading to osteomyelitis.
Common symptoms of malignant otitis externa include severe ear pain, drainage from the ear, swelling of the ear canal or surrounding tissues, fever, and cranial nerve deficits. Due to its potential complications, such as skull base osteomyelitis, cranial nerve palsies, and intracranial abscess formation, prompt diagnosis and aggressive treatment are essential.
Treatment typically involves a combination of antibiotics, often administered intravenously, along with regular cleaning and debridement of the affected ear canal. In some cases, surgical intervention may be necessary to remove infected tissue or drain abscesses. Management of underlying conditions such as diabetes is also important for successful treatment.
Early recognition and appropriate management of malignant otitis externa are crucial to prevent serious complications and improve outcomes. Regular follow-up with healthcare providers is necessary to monitor progress and ensure resolution of the infection.