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[Malignant external otitis. When and which imaging].

K Marsot-Dupuch1, A Tiyriboz, B Meyer

  • 1Service de Radiologie, Hôpital Saint-Antoine, Paris.

Annales D'Oto-Laryngologie Et De Chirurgie Cervico Faciale : Bulletin De La Societe D'Oto-Laryngologie Des Hopitaux De Paris
|January 1, 1991
PubMed
Summary

Malignant external otitis (MEO), a severe Pseudomonas aeruginosa infection, has high mortality. Advanced imaging like CT and MRI are crucial for assessing MEO

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Radiology

Background:

  • Malignant external otitis (MEO) is a severe external auditory canal infection, often caused by Pseudomonas aeruginosa.
  • High mortality (20%) persists despite antibiotic treatment, with risks of skull base diffusion.
  • MEO involves cellulitis, chondritis, and osteomyelitis of the external auditory canal soft tissues.

Purpose of the Study:

  • To evaluate the role of computed tomography (CT), magnetic resonance imaging (MRI), and radionuclide scanning in exploring MEO.
  • To correlate imaging findings with anatomical extension, prognosis, and treatment assessment in MEO patients.

Main Methods:

  • Retrospective analysis of 10 patients with Malignant External Otitis.
  • Utilized CT, MRI, and radionuclide scanning for anatomical assessment.

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  • Correlated imaging findings with clinical progression and treatment response.

    • Main Results:

    • Imaging effectively delineates the anatomical extent of MEO beyond the ear canal towards the skull base and infratemporal fossa.
    • Imaging is valuable for assessing treatment efficacy and duration, though healing criteria remain challenging.
    • Late recurrences of MEO are frequent, and imaging plays a limited diagnostic role in specific clinical presentations.

    Conclusions:

    • CT, MRI, and radionuclide scanning are essential for evaluating the anatomical spread and guiding management of Malignant External Otitis.
    • Imaging provides critical prognostic information and aids in monitoring treatment response for MEO.
    • Despite imaging's utility, definitive healing criteria and frequent late recurrences pose ongoing challenges in MEO management.