Which physical findings are characteristic of malignant otitis externa (MEO)?

Updated: Apr 13, 2020
  • Author: Brian Nussenbaum, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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  • Inflammatory changes are observed in the external auditory canal and the periauricular soft tissue.

  • The pain is out of proportion to the physical examination findings.

    • Marked tenderness is present in the soft tissue between the mandibular ramus and mastoid tip.

    • Granulation tissue is present at the floor of the osseocartilaginous junction. This finding is virtually pathognomonic of malignant external otitis (MEO). Otoscopic examination may also reveal exposed bone.

  • The cranial nerves (V-XII) should be examined.

  • Mental status examination should be performed. Deterioration of the mental status may indicate intracranial complication.

  • The tympanic membrane is usually intact.

  • Fever is uncommon.

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