Malignant external otitis: CT evaluation.

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Abstract
Malignant external otitis (MEO) is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. MEO often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in MEO include obliteration of the normal fat planes in the subtemporal area and patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.