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Ethan Soudry, MD; Ben Zion Joshua, MD; Jaqueline Sulkes, PhD; Ben I. Nageris, MD

Arch Otolaryngol Head Neck Surg. 2007;133(10):1002-1004.

Objective  To compare the characteristics and prognosis of patients with malignant (necrotizing) external otitis (MEO) with and without facial nerve palsy in today's era of third-generation antibiotics.

Design  Comparative retrospective case series.

Setting  Department of Otolaryngology–Head and Neck Surgery, Rabin Medical Center, a tertiary care medical center.

Patients  Forty-eight patients with MEO diagnosed and treated from 1990 to 2004. Eight had facial paralysis and 40 had normal facial nerve function.

Main Outcome Measures  Clinical, laboratory, and imaging findings and survival.

Results  There was no statistically significant difference between patients with and without facial nerve involvement in terms of age, comorbidities, duration of complaints, physical findings, erythrocyte sedimentation rate, and bone scan findings. Computed tomography indicated a more progressive disease in patients with facial nerve involvement. However, no statistically significant between-group difference was found in overall survival.

Conclusion  Although facial nerve involvement is a sign of progression of MEO, it does not, by itself, worsen prognosis.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery (Drs Soudry, Joshua, and Nageris) and Epidemiology Unit (Dr Sulkes), Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (Drs Soudry, Sulkes, and Nageris), Israel.

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