MALIGNANT EXTERNAL OTITIS: A RETROSPECTIVE STUDY OF 22 CASES

Malignant external otitis (MEO) is an osteitis of the skull base, beginning in the external auditory canal with infection of the temporal bone, and can spread towards the skull base, causing bone erosion, cranial nerve deficits, abscesses, and even death[1]. This extremely serious condition occurs mainly in elderly immunocompromised and diabetic patients, constituting a diagnostic and therapeutic emergency [2]. First described in 1959 by Meltzer and Kelemen, J.R. Chandler named it "malignant external otitis" in 1968 to emphasize its lethality [3]. Pseudomonas aeruginosa is the main causative agent (90%), with occasional cases due to Candida and Aspergillus [4]. Imaging helps guide the diagnosis and assesses the extent and effectiveness of treatment. A multidisciplinary approach is required, involving ENT surgeons, infectious disease specialists, microbiologists, endocrinologists, and neuroradiologists [4]. Treatment is based on prolonged dual antibiotic therapy. New anti-Pseudomonas agents and hyperbaric oxygen therapy have improved prognosis [4]. The objectives are to describe the epidemiology, explain the etiopathogenesis, analyze the clinical presentation, determine the usefulness of imaging, update treatment strategies, and define the criteria for recovery.