The history of necrotising otitis externa: from clinical observation to conceptual recognition.

OBJECTIVES

Necrotising otitis externa is a severe, potentially life-threatening infection of the external auditory canal and skull base, first formally described by Chandler in 1968. However, historical literature suggests that its clinical features were recognised long before this, without conceptual unification.

METHODS

A narrative historical review was undertaken using primary and secondary sources, including early otological texts, case reports and modern literature.

RESULTS

Descriptions consistent with necrotising otitis externa appear as early as the nineteenth century, with recurrent observations of severe otitis externa, temporal bone involvement and systemic vulnerability. These remained fragmented across diagnostic categories until the mid-twentieth century. Chandler's work represents a transition from clinical observation to conceptual recognition, providing a unifying framework that enabled consistent diagnosis, comparison and subsequent study of the condition.

CONCLUSION

The evolution of necrotising otitis externa reflects a process of progressive recognition, offering insight into ongoing challenges in defining and studying the disease in contemporary clinical practice.