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Alternative names Return to top
Osteomyelitis of the skull; Otitis externa - malignantDefinition Return to top
Malignant otitis externa is a disorder involving inflammation and damage of the bones and cartilage of the base of the skull. It is caused by the spread of infection from an external ear infection (otitis externa).
Causes, incidence, and risk factors Return to top
Otitis externa, also called swimmer's ear, is an ear infection that occurs in the outer ear. Malignant otitis externa is an uncommon complication of both acute otitis externa and chronic otitis externa. Diabetics and people whose immune systems are compromised from diseases or medications are particularly susceptible to malignant otitis externa.Symptoms Return to top
Signs and tests Return to top
A doctor will look into your ear for signs of an outer ear infection (otitis externa). The head around and behind the ear may be tender to touch. A neurological examination may show that the cranial nerves are affected.
If there is any drainage, the doctor may send it to the lab for a culture to be performed. The purpose of the culture is to look for bacteria or fungus, usually the bacteria Pseudomonas.
To look for signs of a bone infection adjacent to the ear canal, the following tests may be performed:
Treatment Return to top
The goal of treatment is to cure the infection. Treatment is often prolonged, lasting several months, because of the difficulty of treating the bacteria and the difficulties reaching an infection that is within bone tissue.Expectations (prognosis) Return to top
Malignant otitis externa usually responds to prolonged treatment but may return in the future.Complications Return to top
Calling your health care provider Return to top
Call for an appointment with your health care provider if:
Go to the emergency room or call the local emergency number (such as 911) if convulsions, decreased consciousness, severe confusion, or similar symptoms develop.
Prevention Return to top
To prevent an external ear infection, dry the ear thoroughly after exposure to moisture. Avoid swimming in polluted water and protect the ear canal with cotton or lamb's wool while applying hair spray or hair dye (if susceptible to external ear infections).
Treat acute otitis externa completely and do not stop treatment sooner than recommended by your health care provider. Following your doctor's plan completely will reduce the risk of it becoming malignant otitis externa.
After swimming, 1 or 2 drops of a mixture of 50% alcohol and 50% vinegar in each ear will help to dry the ear and prevent infection.
Update Date: 5/6/2003 Updated by: Jason Newman, M.D., Department of Otolaryngology, Kaiser Permanente Medical Group, Washington, DC. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |