Malignant otitis externa: An updated review

Malignant otitis externa is a progressive infection of the external auditory canal and skull base. Pseudomonas aeruginosa is the most isolated microorganism and it affects mostly to diabetic, elderly, and immunocompromised individuals. Non-resolving otalgia and chronic otorrhea are the clinical manifestations presented. Facial nerve palsy is a common and well recognized complication. (Computed tomography) CT scan is useful for initial assessment, Technetium-99m is highly sensitive and is part of the protocol for diagnosis. Treatment should be individualized, with multidisciplinary cooperation among specialties. Management involves systemic antipseudomonal antibiotics and monitoring with radiologic techniques, it also involves the strict control of diabetes. It is essential to follow up the patients for at least a year post-treatment. In refractory malignant otitis externa and affection of facial nerve, surgical management is recommended. We reviewed the most recent studies on epidemiology, clinical manifestations, diagnosis, and treatment to provide an update on Malignant Otitis Externa that can offer an overview for clinical practice and future research. •Malignant otitis externa is a severe infection of the external auditory canal, that disseminates to skull base.•Malignant otitis externa affects diabetic patients, it also affects immunocompromised. Incidence rates increase with age.•Pseudomonas aeruginosa is the most involved organism.•Several studies can be performed to diagnose MOE, being CT scan is crucial for initial approach and Technetium-99m is highly sensitive.•Treatment involves antipseudomonal antibiotics and in refractory cases, surgical management is recommended.