Introduction and objective:

Malignant external otitis (MEO) is an aggressive infection of the soft tissues of the external canal and surrounding structures, which can spread and involve the skull base and the temporomandibular joint (TMJ). It mainly affects immunocompromised patients over 65 years of age. The objective of this study has been to know the characteristics of patients diagnosed with MEO in our hospital in recent years and to establish the diagnosis and therapeutic criteria for this rare disease.

Method:

A descriptive, observational, and retrospective study of patients diagnosed with MEO at the University Clinical Hospital (Valladolid, Spain) between 1996 and 2021 was carried out.

Results:

Nine patients were diagnosed with MEO in the last 25 years, 78% male (7/9), and with a mean age of 76.8 years. All patients manifested the disease early with otalgia, otorrhea and granulation tissue in the external auditory canal (EAC). None had cranial nerve involvement, but four had TMJ invasion and two of the nine patients in the sample died.

Discussion:

Currently the diagnosis of MEO is established from a variety of clinical, laboratory and radiographic findings. Antimicrobial therapy depends on the severity of the infection. Since the availability of systemic antipseudomonal antibiotics, surgical treatment of this pathology is not indicated initially, performing only biopsy or debridement for differential diagnosis with tumor pathology.

Conclusion:

MEO continues to be a disease with serious morbidity and maximum mortality, especially in elderly patients and with other comorbidities.

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