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Page: Complications
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* Chronic otitis externa
Necrotizing External Otitis (Malignant otitis externa)
This rare form of external otitis only occurs in individuals with severe diabetes or severely compromised immune systems. Rather than being a superficial infection of the outer ear, this is an osteomyelitis of the skull base and can extend deeply into the head. Malignant otitis externa begins as a soft tissue infection of the external auditory canal, but soon goes deeper into the bone. Granulation tissue forms on the floor of the canal at the bony-cartilaginous junction. Unlike middle ear infections that involve bone, spread is not into the mastoid, but to compact bone along the middle with eventual extension to the petrous apex. There is often granulation tissue visible in the ear canal, typically at the junction of the bony and cartilaginous canals. Biopsies of affected bone show new bone formation adjacent to areas of destruction. The otic capsule exhibits significant resistance to involvement of the disease and middle ear structures are rarely involved until late in the disease course.
* Spread of infection to other areas of the body
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