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Malignant external otitis: early histopathologic changes and pathogenic mechanism

E Ostfeld, M Segal, B Czernobilsky

    The Laryngoscope
    |June 1, 1981
    PubMed
    Summary
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    Malignant external otitis (MEO) involves opportunistic organisms invading devitalized tissue. Early MEO shows degenerated collagen predating microbial invasion, indicating compromised vasculature as the core disease mechanism.

    Area of Science:

    • Otolaryngology
    • Pathology
    • Infectious Diseases

    Background:

    • Malignant external otitis (MEO) is a severe infection of the external ear canal.
    • Understanding early histopathologic changes is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the early histopathologic features of malignant external otitis (MEO).
    • To elucidate the initial tissue changes preceding microbial invasion in MEO.

    Main Methods:

    • Histopathologic examination of diseased external ear canal tissue.
    • Specimens obtained via en bloc excision through a retroauricular approach in two MEO patients.

    Main Results:

    • Prominent finding: a thick, acellular, degenerated collagen layer in the dermis and cartilage.

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  • This collagen layer appears to predate the microorganism's penetration.
  • Suggests pre-existing tissue devitalization, likely from vascular compromise.
  • Conclusions:

    • MEO develops from opportunistic organisms invading previously devitalized tissue.
    • Vascular compromise is proposed as the fundamental mechanism underlying MEO.
    • Early collagen degeneration is a key indicator of pre-infection tissue compromise.