Otogenic Münchausen syndrome.

Münchausen syndrome is uncommon in otolaryngology. Self-induced otitis externa has rarely been reported, and nothing is known concerning the true incidence of feigned vertigo. We present a patient who has been hospitalized several times and who has undergone ear surgery and treatment at different institutions along the eastern seaboard. She has suffered complications of therapy, including a profound sensorineural hearing loss, and was referred to us for surgical treatment of bizarre intractable otitis externa. The infection failed to respond to medical treatment and was ultimately found to be self-inflicted. Despite psychotherapy, the patient continues to seek further treatment at still other hospitals. This entity must be considered whenever a thorough evaluation fails to yield a reasonable organic diagnosis.