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Updated: Feb 20, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Malignant external otitis: The shifting treatment paradigm
Daniel A Carlton1, Enrique E Perez1, Eric E Smouha1
1Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Importance:
Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat.
Objective:
Determine if there has been a shift in the microbiology and outcomes of MEO.
Design:
A retrospective case series at a tertiary care institution.
Setting:
Inpatient and outpatient tertiary care hospital.
Participants:
12 cases of recent MEO were reviewed.
Main Outcomes And Measures:
The primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO.
Results:
Only 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses.
Conclusions:
Select cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.
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