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Abstract:
Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medically towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.
Insights
Malignant external otitis, a severe Pseudomonas aeruginosa infection, primarily affects elderly diabetics. Computed tomography (CT) effectively visualizes its spread and cranial nerve involvement, aiding diagnosis.
Area of Science:
- Infectious Diseases
- Radiology
- Otolaryngology
Background:
- Malignant external otitis is an aggressive infection.
- It is caused by Pseudomonas aeruginosa.
- Elderly diabetics are the most affected demographic.
Observation:
- The infection spreads from the external canal to the subtemporal area and petrous apex.
- This progression can cause multiple cranial nerve palsies.
- Computed tomography (CT) is used for diagnosis.
Findings:
- CT reveals obliteration of subtemporal fat planes.
- Patchy destruction of the mastoid bony cortex is observed.
- CT identifies cranial nerve exit points and inflammatory mass extent, correlating with clinical findings.
Implications:
- CT is crucial for demonstrating soft tissue involvement at the skull base.
- Accurate CT assessment aids in understanding the disease's extent.
- This imaging modality supports clinical management of malignant external otitis.