Malignant external otitis: a dangerous misnomer?

Review of our experience in treating 16 patients with malignant external otitis, along with survey of the compromised defense mechanisms of diabetic patients, confirms the need for immediate, intense, and vigilant therapy. Radioisotope scans, high-resolution computed tomography scans, and multidirectional tomograms are used to delineate the extent of the disease. Therapy includes intravenous aminoglycoside and penicillin derivatives, limited surgery, and hyperbaric oxygenation. In view of the tendency for this infection to extend beyond the external auditory canal and to produce an invasive lethal osteomyelitis, we feel that the tendency to classify this disease as a variant of diffuse external otitis may foster undertreatment.