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Am J Otolaryngol. 2013 Nov-Dec;34(6):706-9. doi: 10.1016/j.amjoto.2013.07.003. Epub 2013 Aug 5.

Complicated necrotizing otitis externa.

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University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Electronic address:


Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications.

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