What are histologic features 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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Answer

Nadol described the histopathology of 2 temporal bones affected by malignant external otitis (MEO). The infection did not spread through the pneumatized air tracts of the temporal bone. Rather, it spread along the vascular and fascial planes on exiting the temporal bone through the external auditory canal osseocartilaginous junction or fissures of Santorini. The otic capsule appeared to be resistant to the disease process. Linthicum described histopathologic findings in 5 temporal bones. Extensive destruction in the wall of the bony external auditory canal and osteomyelitic destruction of the wall of the fallopian canal in the descending portion of the facial nerve was seen. The infection spread beneath the otic capsule to erode the wall of the carotid canal and then extended into the central skull base.


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