Necrotizing otitis externa (skull base osteomyelitis) – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

October 24, 2020 2:55 am Published by

Necrotizing otitis externa is an osteomyelitis of the temporal bone, which typically begins as an infection of the external ear canal and then extends into the bone and soft tissues of the canal. It mostly commonly occurs in elderly patients, diabetics, and the immunocompromised.

Sn. & Sx.:

  • Fever
  • Extreme otalgia
  • Purulent otorrhea
  • Hearing loss

dDx.:

  • Otitis (AOE, AOM)
  • Herpes simplex/zoster
  • Auricular cellulitis
  • Mastoiditis

Sequelae:

  • Systemic infection
  • Lower cranial nerve palsies
  • Facial nerve paralysis
  • Deafness

Work up:

  • Imaging (temporal bone CT, MRI)

Tx.:

  • IV antibiotics

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This post was written by Omar Rifai