Learning objectives
- Radiologic diagnosis CT/MRI of external necrotizing otitis before instauring treatment.
- To assess the extension of inflamatory process to surrounding soft tissues.
- To highlight the mainstey role of technical imaging CT+MRI in complications diagnosis
Background
Milgnant external otitis( MEO) also referred to Necrotizing otitis externa is a rare and life threatening disease that affects diabetic or immunocompromised patients (HIV , under chemotherapy).
It takes its origins from the external auditory canal in the osseous and cartilaginous junction as a persistent infection that spreads to the surrounding osseous structures (temporal bone essentially ) with involvement of the skull base and surrounding soft tissues.
Pseudomonas aeruginosa is involved in a high percentage of all cases of MEO (80-90%).
Other causative agents such...
Findings and procedure details
Diagnosis suspicion
Diagnosis of MEO is suspected in patients suffering from persistent otorreha and otalgia
Sometimes Cranial nerve palsy: essentially homolateral facial nerve palsy .
MEO is a challenging disorder to diagnose and imaging should be performed as soon as diagnosis is suspected.
(CT) being as an easy and fast method to acquire to overview of the Temporal bone ,is the
most commonly used imaging modality for diagnosis and follow-up of MEO.
CT protocol:
The examination consists of acquisition in the axial with high resolution...
Conclusion
Malignant external otitis is a fatal disease .
Imaging CT/MRI has a key role in confirming diagnosis , extension to soft tissue , detecting comlpications and evolution under treatment.
Personal information and conflict of interest
S. Sahraoui; Tunis/TN - nothing to disclose S. Ines; Tunis/TN - nothing to disclose M. Jrad; Tunis/TN - nothing to disclose S. Boukriba; Tunis/TN - nothing to disclose
References
1-A Comprehensive Review of Skull Base Osteomyelitis: Diagnostic and
Therapeutic Challenges among Various Presentations .Khan M ADOI: 10.4103/ajns.AJNS_90_17
2-Osteomyelitis of the Temporal Bone:Terminology, Diagnosis, and Management.Sampath Chandra Prasad1DOI http://dx.doi.org/
10.1055/s-0034-1372468.
3-Advanced Imaging Techniques in Skull Base Osteomyelitis Due
to Malignant Otitis ExternaA. M. J. L. van Kroonenburghoi.org/10.1007/s40134-018-0263-y