Unusual Malignant External Otitis in Mastoidectomized Temporal Bone: A Case Report

Abstract

We here report an unusual case of malignant external otitis (MEO) in mastoidectomized temporal bone, and discuss its diagnosis and treatment course. A 67-year-old man with a history of diabetes mellitus (DM) and mastoidectomy presented with persistent right earache and discharge. The condition was first misdiagnosed as acute exacerbation of chronic otitis media. After revision mastoidectomy failed, a correct diagnosis of MEO was made. Intravenous ciprofloxacin and cefepime as well as concurrent hyperbaric oxygen (HBO) therapy were administered for 7 weeks. Surgical debridement in the form of mastoid exteriorization was also performed. Diagnosis of MEO in mastoidectomized temporal bone was difficult, and the relatively successful control of DM and negative bacterial culture from ear discharge further masked MEO. Mastoid cavity exteriorization in addition to prolonged administration of antibiotics and HBO therapy might be useful for MEO management.