Diagnosis, complications, and treatment of malignant otitis externa.

Malignant otitis externa (MOE) is a severe penetrating infection which has spread outside the confines of the external auditory canal to involve temporal bone, mastoid air cells and periaural soft tissues. It is a rare but important condition, having a mortality rate of between 23%-75%. Clinical diagnosis in the early stage is difficult because the symptoms are similar to acute otitis externa. Diabetes Mellitus is an important predisposing factor present in up to 94% of patients. Two cases of MOE are presented underlining the clinical findings, spectrum of activity and treatment of the disease, and stressing the importance of early diagnosis.