Malignant Otitis Externa – Causes, Symptoms, Diagnosis, & Treatment
What is malignant otitis externa?
Malignant otitis externa is a severe infection of external ear canal and bones of the surrounding areas at the base of the skull. It can affect temporal, jaw, and adjacent bones. Malignant otitis externa is a rare infection. It is also called swimmer’s ear, although it is not caused by water remaining in the ear. This infection usually affects elderly people with diabetes mellitus. Although the name suggests malignancy, it is an aggressive infection rather than cancer. If left untreated, this serious infection can lead to many complications including death.
What causes malignant otitis externa?
Malignant otitis externa is mostly caused by hard-to-treat bacteria, such as pseudomonas aeruginosa or Staphylococcus aureus. The infection spreads from the external ear canal to the nearby tissues and bones at the skull base. The infection may lead to damage of the bones. This serious infection can also affect the cranial nerves, brain, or other parts of the body if it continues to spread.
The following are the risk factors for this infection:
- Weak immune system
What are the symptoms of malignant otitis externa?
The following are the common symptoms:
- Ear pain that gets worse when you move your head.
- Persistent yellow or green foul-smelling drainage from the ear.
- Hearing loss.
- Persistent itching in the ear or ear canal.
- Difficulty swallowing.
- The weakness of the facial muscles.
How is malignant otitis externa diagnosed?
Your doctor will check the affected ear and look for signs of an outer ear infection. The doctor may find the areas of the skull base around or behind the ear tender to touch. He/she may also perform a neurological exam to see if the cranial nerves are affected. If the doctor finds any drainage, a sample of it will be sent to the lab for a culture to find the cause of the infection.
The doctor may do the following tests to look for signs of a bone infection around the ear:
- MRI of the head
- Head CT scan
- Radionuclide scan
How is malignant otitis externa treated?
The aim of the treatment will be to cure the infection. Treatment may continue for several months, as it is difficult to treat the bacterial infection deep in the bone tissue, which is hard to reach.
Your doctor may recommend long-term oral or intravenous antibiotics. The treatment with antibiotics may continue until tests show the inflammation has completely gone.
Sometimes, the doctor may recommend surgical debridement to remove dead or damaged tissue from the skull.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.