Malignant Otitis Externa: A Comprehensive Review

Abstract

Malignant otitis externa (MOE) is a severe, potentially life-threatening infection of
the external auditory canal, most commonly affecting elderly individuals with
diabetes mellitus or immunocompromised states. Despite its name, MOE is not a
neoplastic process but a progressive and invasive infection, often caused by
Pseudomonas aeruginosa. It may extend to involve the skull base and cranial nerves,
leading to severe morbidity and mortality. This review discusses the current
understanding of the disease’s epidemiology, anatomy, pathophysiology, clinical
presentation, diagnostic strategies, treatment modalities, and long-term implications.
Emphasis is placed on evidence-based approaches, diagnostic imaging advances,
emerging antimicrobial resistance, and multidisciplinary management.