Malignant Otitis Externa (MOE) causing cerebral abscess and facial nerve palsy

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Download Full-text

Facial nerve palsy as a complication of ear syringing

The Journal of Laryngology & Otology ◽

10.1017/s0022215112000886 ◽

2012 ◽

Vol 126 (7) ◽

pp. 714-716 ◽

Cited By ~ 2

Author(s):

A M Thomas ◽

B Poojary ◽

H C Badaridatta

Keyword(s):

Facial Nerve ◽

External Auditory Canal ◽

Otitis Externa ◽

Nerve Palsy ◽

Surgical Intervention ◽

Facial Nerve Palsy ◽

Unusual Complication ◽

Vestibular Loss ◽

Case Presentation ◽

Dramatic Presentation

AbstractIntroduction:Syringing of the ear is one of the most common procedures performed for cleaning cerumen from the external auditory canal. Common complications following syringing are pain, external auditory canal trauma and otitis externa. Hearing and vestibular loss have also been reported as complications. However, we are unaware of any report of facial nerve palsy as a complication of ear syringing. Such a case is reported.Case presentation:We describe a case of facial nerve palsy as a complication of syringing, which demonstrates the dramatic presentation of this condition and emphasises the need for great care while syringing the ears.Conclusion:It is important to be aware of this unusual complication with its distinctive presentation. Surgical intervention should be undertaken at the earliest opportunity, for favourable results. A risk-minimising strategy for ear syringing is recommended.

Download Full-text

Herpes zoster oticus with meningitis masquerading as malignant otitis externa

BMJ Case Reports ◽

10.1136/bcr-2019-229569 ◽

2019 ◽

Vol 12 (6) ◽

pp. e229569

Author(s):

Harriet A Cunniffe ◽

Nicholas G Cunniffe

Keyword(s):

Otitis Externa ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Clinical Course ◽

Abducens Nerve ◽

Varicella Zoster ◽

Seventh Cranial Nerve ◽

Cranial Nerve Palsies ◽

Malignant Otitis Externa

This is a case of an 85-year-old woman whom was admitted with otalgia and an abducens nerve palsy alongside a Pseudomonas otitis externa; she was presumed to have malignant otitis externa. However, despite optimum treatment and resolution of her otitis externa, she went on to develop an ipsilateral facial nerve palsy and sensorineural hearing loss. After further investigation, it was discovered that varicella-zoster meningitis was causing her polyneuropathy. She eventually responded to antivirals and steroids and, at follow-up, her sixth and seventh cranial nerve palsies had completely resolved, though a hearing deficit remained. This case highlights the importance of keeping a diagnosis under review, with the help of the multidisciplinary team, when the clinical course is not progressing as expected.

Download Full-text