Masked diabetic mastoiditis.

Seven cases of elderly diabetics suffering from ths so-called 'malignant external otitis' are presented. Chandler (1968) and others consider that this disease is localized to the external ear canal. We do not agree and believe that it is due to a masked middle-ear infection extending through the tympano-mastoid cells to the mastoid process, sparing the antrum and bulging into the floor of the external meatus. In time, extension to petrous apex results in petrositis and a fatal end in many cases.