Necrotizing external otitis: literature review and novel management recommended for necrotizing external otitis

Czech version

Authors: T. Bakaj ¹; L. Quinn ²; L. Bakaj Zbrožková ³; R. Salzman ¹
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN Olomouc ¹; Klinika nukleární medicíny LF UP a FN Olomouc ²; Radiologická klinika LF UP a FN Olomouc ³
Published in: Otorinolaryngol Foniatr, 75, 2026, No. 2, pp. 146-156.
Category: Review Article
doi: https://doi.org/10.48095/ccorl2026146

Overview

Necrotizing external otitis (NEO) is a rare but serious disorder of skull base bone (s) (osteomyelitis). It is most often a complication of external otitis, less commonly of chronic suppurative otitis media (CSOM). Elderly patients are predisposed to the disease and thus more commonly involved. According to a recent study’s findings, the incidence of the disease increases with increase in cases of diseases which lead to immunosuppression and with the aging of the population. The course of the disease is very variable and despite current trends in medical diagnostic methods and treatment options the disease is associated with a high morbidity and mortality rate. This is related mainly to diagnostic delays, short duration/incomplete treatment and inappropriate duration of follow-up of the patients. The purpose of this literature review is to provide a list of the current classification of the disease, symptoms, diagnostic criteria, treatment and follow-up of the patients. The authors introduce the novel management protocol for necrotizing external otitis at the Department of Otorhinolaryngology and Head and Neck surgery University Hospital Olomouc based upon the literature review and own long-term experience with the patients.

Keywords:

necrotizing external otitis – malignant external otitis – skull base osteomyelitis – 99mTc-HMPAO – WBC scintigraphy

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