Malignant otitis externa
*Definition : inflammation of external ear which extends to base of skull *Incidence :rare, occurs in diabetic patients and in elder *organism :pseudomonus aeruginosa *pathodenesis: organism secrets enzymes which lead to necrotizing vasculitis *symptoms :stabbing otalgia, deafness, bloody purulant discharge *signs :diffuse otitis externa, granulation tissue at junction ()bony and cartiliginous parts of external auditory meatus *complications :osteomyelitis, extends to stylomastoid foramen leading to facial nerve paralysis and to jugular foramen leading to paralysis of 9,10,11,12 cranial nerves It may lead to intracranial extension *investigations :CT, fasting blood sugar test, hearing tests, culture sensitivity test *treatment " control on DM Intensive antibiotic for 6 weeks Aural toilet with local antibiotic drops Surgical debridement of granulation tissue and necrotic tissue
