[Malignant otitis externa: apropos of 19 cases].

In the Anglo-Saxon literature, necrotizing otitis in the diabetic patient, known as malignant otitis externa (MOE), represents a specific and in many ways serious entity. We report on our personal experience with 19 cases of MOE with hospitalization and a 9-year follow-up. Our diagnostic criteria are as follows: all our patients are diabetic (with diabetes revealed twice by the MOE). Otalgia is a predominant feature of the clinical picture, with facial palsy being recorded in practically all our patients. A pyocyanic germ was responsible in 16 cases. The use of CT instead of Tc99 scintigraphy enabled the assessment of the extent of the complaint. Surgical treatment (mastoidectomy), recommended for our first patients, is now considered pointless due to its lack of efficacy against an already extensive process, and with the arrival on the market of new families of ATB's, in particular the quinolones. It would appear that this general treatment, combined with local treatment, provides a better control of the evolution of the MOE, which nonetheless carries a high mortality rate estimated at 18%. On the basis of this series, we present the data in the literature, recalling the diagnostic criteria, the value of skull base imaging and the criteria of recovery.