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Malignant otitis externa Radiology

Abstract. Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medically towards the petrous apex leading to multiple cranial nerve palsies Necrotizing (malignant) otitis externa (NOE) is a spreading necrotizing infection of the external auditory canal (EAC) soft tissue that can produce an osteomyelitis of the entire skull base. It is most commonly caused by pseudomonas but is also less commonly caused by Staphylococcus aureus and Proteus mirabilis Soft tissue thickening along the left external auditory canal. Extensive skin thickening and subcutaneous inflammatory change in the pre and post auricular regions. Heterogeneously enhancing soft tissue thickening extending superiorly along the temporalis and subgaleal space of the temporal bone

This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomyelitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis Malignant external otitis (MEO) is an infection that affects the external auditory canal and temporal bone. The causative organism is usually Pseudomonas aeruginosa, and the disease commonly manifests in elderly patients with diabetes Otitis externa refers to inflammation of the external ear. Epidemiology. It is quite a common condition and may affect up to 10% of people during their lifetime. Pathology. It can present in several forms: acute otitis externa; chronic otitis externa; necrotizing otitis externa; Etiology. There are several known risk factors which include 1: swimmin Malignant (necrotizing) otitis externa is a particularly aggressive life-threatening form of infection caused by Pseudomonas aeruginosa infection typically in elderly diabetics and individuals with other immunosuppressed states, such as HIV patients or those who have undergone chemotherapy. Clinically, a high index of suspicion in the susceptible patient population is required for diagnosis

Malignant external otitis: CT evaluation

To describe and illustrate the spectrum of imaging characteristics of malignant otitis externa in order to avoid missing that diagnosis. Background Malignant otitis externa (MOE) is a potentially life-threatening and debilitating disorder that involves inflammation and damage of the bone and soft tissues of the skull base Malignant otitis externa is a life-threatening infection that mainly affects the external auditory canal and skull base, and the infection can also invade the stylomastoid and jugular foramina 5. Phillips JS, Jones SE. Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa. Cochrane Database SystRev. 2013 May 31;(5):CD004617. 6. PulciniC, MahdyounP, CuaE, GahideI, Castillo L, Guevara N. Antibiotic therapy in necrotisingexternal otitis: case series of 32 patients and review of the literature Otitis externa is a common ear infection also known as swimmer's ear. It develops in the ear canal leading to the eardrum. In some cases, otitis externa can spread to surrounding tissue, including..

Three patients who were considered to be in clinical remission had positive Tc-99m scans and normal Ga-67 scans. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis arises from malignant otitis externa (MOE); the diffuse skull base and adjacent soft tissue involvement may be mistaken at initial imaging for advanced nasopharyngeal carcinoma (NPC), especially if there is no prior knowledge of MOE, direct spread from the sphenoid sinus or in atypical presentations of MOE. Thi

Lifted from Rubin Grandis J, Branstetter BFt, Yu VL. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. The Lancet Infectious diseases. 2004;4(1):34-9 Facts: Malignant Otitis Externa. Severe infection of the external auditory canal (EAC) and skull base. Elderly diabetics and immunocompromised patients. Most common organism = P. aeruginosa. Extension into deep structures or chronic osteomyelitis may occur without signs on local examination Malignant external otitis is a severe infection of the external auditory canal and skull base, which most often affects elderly patients with diabetes mellitus. This disease is still a serious disease associated with cranial nerve complications and high morbidity-mortality rate. Malignant otitis externa requires urgent diagnosis and treatment Malignant external otitis, also referred to as skull base osteomyelitis or necrotizing otitis externa, is typically a Pseudomonas osteomyelitis of the temporal bone. Methicillin-resistant Staphylococcus aureus (MRSA) has also been reported as a cause. Soft tissue, cartilage, and bone are all affected by malignant external otitis Malignant (necrotizing) external otitis (also termed malignant otitis externa) is an invasive infection of the external auditory canal and skull base, which typically occurs in elderly patients with diabetes mellitus

Malignant otitis externa, an increasing burden in the twenty-first century: review of cases in a UK teaching hospital, with a proposed algorithm for diagnosis and management. The Journal of Laryngology & Otology, Vol. 133, Issue. 05, p. 356 Facts: Malignant Otitis Externa. Severe infection of the external auditory canal (EAC) and skull base. Elderly diabetics and immunocompromised patients. Most common organism = P. aeruginosa. Extension into deep structures or chronic osteomyelitis may occur without signs on local examination Objectives: This study looks at case series of malignant otitis externa patients and outlines the detailed structural (radiological) and functional (radionuclide) investigations and discusses their utility in the initial diagnosis, patient management, and follow-up. Methods: Three case examples were scrutinized. The patients were investigated by computerized tomography (CT), magnetic resonance.

Neuroradiology On the Net: Malignant otitis externa

1. Chandler JR. Malignant otitis externa, Laryngoscope 1968;78:1257-92 2. Hobson CE, Moy JD, Byers KE, Raz Y, Hirsch BE, McCall AA.Malignant otitis externa:Evolving Pathogens and implications for Diagnosis andtreatment.Otolaryngol Head NeckSurg.2014 Mar 26 3. Bayardelle P, Jolivet-Granger M, Larochelle D. Staphylococcal malignant external otitis Grandis JR et al: Necrotizing (malignant) external otitis: prospective comparison of CT and MR imaging in diagnosis and follow-up. Radiology. 196 (2):499-504, 1995. Mingkwansook V et al: CT Findings in the External Auditory Canal after Transcanal Surgery Malignant otitis externa is more common in males and warm, humid climates. Presenting symptoms include severe, deep seated otolgia, purulent otorrhea, hearing loss and headaches. Facial nerve palsy, swallowing problems and hoarseness may be present if cranial nerve involvement has occurred. On examination

Malignant Otitis Externa 1. Dr. Mamoon Ameen 2. Malignant otitis externa is an aggressive and potentially life-threatening infection of the soft tissues of the external ear and surrounding structures, quickly spreading to involve the periosteum and bone of the skull base of a synchronous malignancy and malignant otitis externa [ , ]. Both malignant otitis externa and squamous cell carcinomas of the external auditory canals are rare entities, and it is even rarer to have both occurring at the same time. Both pathologies present in a remarkably similar manner clinically, radiologically, and on laboratory. Background. Otitis externa, colloquially known as swimmers ear or tropical ear, is an infection of the external auditory canal (Figure 1). In the elderly, diabetics, AIDS patients, and the immunocompromised it may progress to Malignant Otitis Externa (MOE). Also known as Necrotizing External Otitis, it is an aggressive form of OE

Necrotizing (Malignant) Otitis Externa Radiology Ke

  1. to Malignant Otitis Externa A. M. J. L. van Kroonenburgh1 • W. L. van der Meer1 • R. J. P. Bothof2 • M. van Tilburg3 • J. van Tongeren3 • A. A. Postma1 Published online: 22 January 2018 The Author(s) 2018. This article is an open access publication Abstract Purpose of Review To give an up-to-date overview of th
  2. This section of the website will show MRI Malignant otitis externa (MOE) T1 axial images
  3. In malignant otitis externa with skull base osteomyelitis, it has been reported that infections preferentially travel along vascular and fascial planes, rather than pneumatized tracts. In our images, the CT scan showed opacification of the left mastoid air cells and middle ear cleft which is suggestive of an infection [7]
  4. Malignant otitis externa (MOE) is an invasive bacterial infection of the external auditory canal and skull base. It involves the soft tissues adjacent to the skull base and often progresses to osteomyelitis of the skull base. It occurs primarily in elderly patients with diabetes mellitus and is nearly always due to Pseudomonas aeruginosa
  5. Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies

Malignant otitis externa progressing to skull base osteomyelitis is an aggressive infection of the temporal bone and skull base, associated with possible involvement of the facial nerve, carotid artery, jugular vein and mastoid. It was termed malignant, due to the high mortality rate and poor response to treatment Definition / general. Initially affects external auditory canal with symptoms of acute otitis externa; later pain, purulent otorrhea and swelling; may progress to cellulitis, chondritis, osteomyelitis ( Rev Stomatol Chir Maxillofac 2006;107:167 ), involve middle ear space or base of skull, and cause cranial nerve palsies, meningitis, venous. Radiology. Computed tomography (CT) scans of the temporal bone with and without contrast are usually obtained in patients who have severe otalgia despite the initiation of medical therapy, or in the presence of granulation tissue in the ear canal, to rule out malignant otitis externa Skull base osteomyelitis secondary to malignant otitis externa mimicking advanced nasopharyngeal cancer: MR imaging features at initial presentation. Am J Otolaryngol . 2017 Jul - Aug. 38 (4):466. This study looks at case series of malignant otitis externa, outlines detailed structural (radiological) and functional (radionuclide) investigations, and discusses their utility in the initial diagnosis, patient management and follow up of this condition. Patients were investigated by computerized tomography (CT), magnetic resonance imaging (MRI), two-phase planar and single-photon emission.

Malignant otitis externa Radiology Case Radiopaedia

1. Introduction Malignant otitis externa (MOE) is a rare and potentially fatal invasive infection of the skull base. It can arise as a result of an infection of the external auditory canal malignant otitis externa, the middle ear, and sinusitis and as a complication of surgery of the skull base [1-3] experience with the management of Malignant Otitis Externa. METHODS Over the last 6 years (1997-2003) 9 patients with the preliminary diagnosis of Malignant Otitis Externa (MOE) were admitted to the ENT ward at King Fahd Hospital of the University for investigation and further treatment. A detailed histor Malignant Otitis Externa, though a misnomer, definitely alarms the surgeon, the idea that it behaves and spreads like a malignancy, in elderly diabetics, and if not treated deligently, can be fatal. Though the main line of treatment is medical, surgical intervention should not be deferred if indicated. We are presenting one such case where we have not only saved the patient's life but also. ENT - MCQ 9 - Features of malignant otitis externa. Which of the following is not a typical feature of malignant otitis externa? a) Caused by Pseudomonas aeruginosa. b) Patients are usually old. c) Mitotic figures are high. d) Patient is immune compromised. Correct answer : c) Mitotic figures are high. Malignant otitis externa is an.

Jaskaran Singh and Bhanu Bhardwaj, The Role of Surgical Debridement in Cases of Refractory Malignant Otitis Externa, Indian Journal of Otolaryngology and Head & Neck Surgery, 10.1007/s12070-018-1426-0, 70, 4, (549-554), (2018) Malignant otitis media 1. Presented by Kiran Patil 2. Introduction: Chandler published the first series of patients with progressive osteomyelitis of the temporal bone and termed the condition malignant otitis externa. 3. Definition Invasive infection in external auditory canal and skull base. 4 Hey guys, this is Indian Medico. In this video, we are going to see about malignant otitis externa. This is a concise presentation from diseases of external.

Necrotizing (malignant) external otitis: prospective comparison of CT and MR imaging in diagnosis and follow-up. Radiology . 1995 Aug. 196 (2):499-504. [Medline] Malignant otitis externa (MOE), also known as necrotizing otitis externa, is an invasive bacterial infection that involves the external auditory canal and skull base. It is a complication of. Malignant otitis externa is a serious disease that usually affects elderly diabetic patients and other immunocompromised patients. Close monitoring of inflammatory parameters is the main factor in determining prognosis. Planning treatment management and predicting outcome depends on clinical evaluation and proper radiological evaluation 27 Mar 2020. stage IV malignant otitis externa detected by single-photon emission computed tomography/computer tomography might be associated with 100% mortality in adults (Otolaryngol Head Neck Surg 2019 Aug

Malignant external otitis: CT evaluatio

Malignant (Necrotizing) Otitis Externa Findings: Noncontrast temporal bone CT demonstrates abnormal opacification of the left mastoid air cells and middle ear cavity as well as the external auditory canal. The soft tissue windows show infiltration of the left parapharyngeal and peristyloid fat planes Abstract. Malignant otitis externa, although it is not a malignancy, it behaves and spreads like one, hence the name. [1] The first case of MOE was reported in 1938, and the term 'malignant otitis externa' was described later by Chandler in 1968, due to its high fatality rate in that time. [2] Malignant otitis externa is a life-threatening. Objectives . To discuss the management of a squamous cell carcinoma in the presence of malignant otitis externa. Study Design . We present only the third reported case in the literature of a synchronous tumour with malignant otitis externa in the literature. Methods . A case report and review of malignant otitis externa and squamous cell carcinomas of the external auditory canal are discussed.

Video: Malignant external otitis: early scintigraphic detection

Necrotizing infection of the soft tissue of the external auditory canal. Pseudomonas aeruginosa is most common causative organism (accounts for 95% of cases) Staphylococcus aureus accounts for the remaining cases. Complication of Otitis Externa. Infection extends into ear canal cartilage. Passes to Temporal Bone via Santorini's Fissures The usefulness of radionuclear scanning in the treatment of 18 patients with necrotizing progressive ''malignant'' external otitis is discussed. A Tc 99-m bone scan, a valuable test since results are positive in early cases of osteomyelitis of the temporal bone and base of skull, showed increased uptake in all 18 patients Malignant otitis externa is a disorder that involves infection and damage of the bones of the ear canal and at the base of the skull. Causes Malignant otitis externa is caused by the spread of an outer ear infection (otitis externa), also called swimmer's ear Otitis externa responds well to treatment, but complications may occur if it is not treated. Individuals with underlying diabetes, disorders of the immune system, or history of radiation therapy to the base of the skull are more likely to develop complications, including malignant otitis externa

Malignant otitis externa with bilateral cranial nerve

USMLE Step 2CK Podcasts - Listen on Spotify : http://spoti.fi/2WD5LavGoogle Podcasts :http://bit.ly/2JdSeTQ Malignant Otitis Externa.Levensons criteria for d.. Malignant or necrotising otitis externa. All patients in this group should have debridement of granulation tissue. Patients can be given oral ciprofloxacin for 6 to 8 weeks. Bernstein JM, Holland NJ, Porter GC, et al. Resistance of Pseudomonas to ciprofloxacin: implications for the treatment of malignant otitis externa Otitis externa is an inflammatory process of the external auditory canal. In one recent study,1 otitis externa was found to be disabling enough to cause 36 percent of patients to interrupt their. Malignant (necrotizing) external otitis (also termed malignant otitis externa) is an invasive infection of the external auditory canal and skull base, which typically occurs in elderly patients with diabetes . ›. External otitis: Pathogenesis, clinical features, and diagnosis. View in Chinese Malignant otitis externa is a severe debilitating disorder that involves the external auditory canal. The term Malignant Otitis Externa is actually a misnomer. It has been coined to indicate the destructive capabilities of this disorder. This article discusses etiopathogenesis, diagnostic problems and various management modalities available to manage the same

Fungal malignant otitis externa (FMOE) is a serious and potentially life-threatening condition that is challenging to manage. Diagnosis is often delayed due to the low sensitivity of aural swabs and many antifungal drugs have significant side effects. We present a case of FMOE, where formal tissue sampling revealed the diagnosis and the patient was successfully treated with voriconazole, in. localized otitis externa - due to folliculitis or furuncle in external ear canal 1; malignant otitis externa - aggressive infection of external auditory canal and deep periauricular tissues that can lead to osteomyelitis of the skull base 1,2,3. also called malignant external otitis, necrotizing external otitis, necrotizing otitis externa Malignant otitis externa (MOE) also referred to as necrotizing otitis externa or skull base osteomyelitis can be defined as otitis externa with progression to skull base osteomyelitis. The causative organism is almost universally Pseudomonas, which invades via the fissures of Santorini, located in the cartilaginous, lateral 1/3 of the external. Malignant external otitis, also known as necrotizing external otitis, refers to osteomyelitis of the skull base (characteristically Pseudomonas aeruginosa), usually caused by persistent external otitis in diabetic or immunocompromised patients. Early in the disease, CT may show thickened mucosa of the floor of the external auditory canal and.

Malignant Otitis Externa-MRI - Sumer's Radiology Blo

2 Malignant Otitis Externa CPG v1 24082018 On Investigation: Ear canal swab o Must be taken before commencing any treatment o Only swabs with transport medium should be used to maximize sensitivity of culture results. o Swabs should be sent for standard M/C/S and be labeled external auditory canal - malignant otitis externa Back . Malignant otitis externa (MOE) DWI b0,b100 and ADC image Malignant external otitis is a severe infection of the external auditoy canal, characterized by high gravity and mortality. It can arrive to skull base and originate intracranial complications. The most frequent pathogenic agent is Pseudomonas aeruginosa. Authors described two cases of external malignant otitis caused by Staphylococcus aureus, explaining clinical features, progression. Malignant otitis externa is otitis externa which has spread to cause osteomyelitis of the skull base. all tissues (soft tissue, cartilage, and bone) area affected as osteomyelitis spreads along the skull base. It is due to Pseudomonas aeruginosa and anaerobes causing a mound of tissue in the external canal. P aeruginosa is isolated from exudate.

Otitis externa Radiology Reference Article Radiopaedia

Malignant Otitis Externa (MOE) is a necrotizing infection of the external auditory canal characterized by extension into nearby soft tissue and bony structures that can potentially lead to mastoiditis, skull base osteomyelitis, cranial nerve palsies, and rarely, intracranial complications Malignant otitis externa is caused by the spread of an outer ear infection (otitis externa) also called swimmer's ear. It is not common. Risks for this condition include: External otitis is often caused by bacteria that are hard to treat, such as pseudomonas. The infection spreads from the floor of the ear canal to the nearby tissues and into.

Malignant Otitis Externa/ Skull Base osteomyelitis

External Otitis Radiology Ke

Our LATEST youtube film is ready to run. Just need a glimpse, leave your valuable advice let us know , and subscribe us! Deeply thanks! We are pleased to provide you with the picture named Necrotizing Malignant Otitis Externa Diagram.We hope this picture Necrotizing Malignant Otitis Externa Diagram can help you study and research. for more anatomy content please follow us and visit our website. A prospective study was conducted at a tertiary referral hospital to evaluate the clinical presentation, co-morbid conditions and treatment response in the management of malignant otitis externa. Among the 34 patients enrolled in the study, 30 were male and 4 were female, aged between 48 to 61 years. Excruciating ear ache was the most common presenting symptom followed by persistent ear.

Imaging of malignant external otiti

Malignant otitis externa (MOE), or necrotizing otitis externa, is an uncommon severe, progressive infection of the external auditory canal, skull base, and adjacent structures. Necrotizing otitis externa with associated skull base osteomyelitis was first reported in the liter-ature in 1838.1 In 1968 Chandler described the condi treatment response. Early diagnosis of malignant otitis is a difficult challenge. We present an illustrative case of necrotizing otitis externa and suggest some strategies to avoid diagnostic and treatment pitfalls. Case Outline A 70-year-old patient presented with signs of malignant otitis externa, complicated by peripheral facial palsy malignant otitis externa; Email alerts. malignant otitis externa. Otorrhoea with facial palsy in a child. Yi-Jia Chen, Radiology (1057) Rehabilitation medicine. Disability (322) Other rehabilitative therapies (13) Physiotherapy (114) Renal medicine (289) Respiratory medicine. Airway biology (251

Malignant otitis externa, an increasing burden in the twenty-first century: review of cases in a UK teaching hospital, with a proposed algorithm for diagnosis and management. Hutson KH, Watson GJ. JOURNAL OF LARYNGOLOGY AND OTOLOGY 2019;133:356-62 Otoscopic findings of malignant otitis externa include: A. Granulation tissue at the bony cartilaginous junction. B. Perforation of ear drum. C. External auditory canal skin soggy and oedematous. D. Attic perforation

Malignant external otitis: early scintigraphic detectio

Malignant otitis externa (MOE) is an aggressive and potentially life-threatening infection of the soft tissues of the external ear and its surrounding structures, which quickly spreads to involve periosteum and bone of the skull base. The most common causative organism of malignant otitis externa is Pseudomonas aeruginosa Malignant Otitis Externa (MOE), or skull base osteomyelitis, is an aggressive infection that predominantly affects elderly, diabetic, or immunocompromised patients, and is associated with high disease-specific mortality. MOE is suspected in the setting of external otitis associated with granulation tissue and pain; biopsy is obtained to rule.

Necrotizing (Malignant) External Otitis - American Family

Malignant otitis externa is a necrotizing infection of the external ear canal and surrounding soft tissue and bone, usually caused by Pseudomonas aeruginosa.The infection classically occurs in diabetic patients, however recently, several patients with the acquired immunodeficiency syndrome (AIDS) have been reported to have malignant otitis externa Objective: To review the literature about Malignant Otitis Externa. Methodology: A comprehensive review of existing knowledge that is available in literature has been summarised in this article. Results: There is a rising incidence of Malignant Otitis Externa in the developing countries, predominantly seen in elderly diabetics. The common organism isolated is Pseudomonas aeruginosa though.

MALIGNANT OTITIS EXTERNA - CT FINDINGS - YouTub

This chapter discusses Chandler's 1968 paper on Malignant external otitis including the design of the study (outcome measures, results, conclusions, and a critique). Access to the complete content on Oxford Medicine Online requires a subscription or purchase All are true about malignant otitis externa except - [A]. ESR is used for follow up after treatment [B]. Granulations are seen on superior wall of external auditory canal [C]. Severe hearling loss is the chief presenting complaint [D]. Pseudomonas is the most common caus Acute otitis externa. Source: Canadian Paediatric Society (Add filter) Published by Canadian Paediatric Society, 01 February 2013. Acute otitis externa, also known as 'swimmer's ear', is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or..

Malignant Otitis Externa: Practice Essentials

Malignant otitis externa. Malignant otitis externa is a disorder that involves infection and damage of the bones of the ear canal and at the base of the skull. The ear consists of external, middle, and inner structures. The eardrum and the three tiny bones conduct sound from the eardrum to the cochlea Malignant external otitis is infection of the external ear that has spread to the skull bone (temporal bone) containing the ear canal, the middle ear, and the inner ear. Malignant external otitis occurs mainly in people with a weakened immune system and in older people with diabetes. Infection of the external ear, usually caused by the bacteria. Introduction. Malignant otitis externa is an invasive infection which destroys the external ear canal and can develop and result in skull base osteomyelitis, meningitis and paralysis of the cranial nerves.(1) This disease are generally observed in patients with primary or secondary immunodefficiency, including elderly diabetic patients (greater than 90%), patients with HIV, chronic leukemia.

Pseudomonas and Aspergillus interaction in malignant

Malignant otitis externa (MOE) originates as inflammation of the epidermis in the external auditory canal, and spreads to the surrounding structures and neck, leading to abscess formation. MOE is associated with an immunosuppressive condition and diabetes. Patients with MOE suffer from otalgia, otorrhea and hearing loss. According to the literature, surgery to the temporomandibular joint is. Definition. Otitis externa is redness and swelling of the ear canal. The ear canal is the tube leading from the outer ear to the eardrum. Otitis externa may be: Short-term (acute) Long-term (chronic) Some people develop malignant otitis externa. This is an infection of tissue and bone around the ear and skull base Otitis externa (OE) is defined as inflammation of the external ear canal. 1 It is estimated to affect 1% of the UK population each year. 2 OE can be classified by the duration of symptoms: Acute: <3 weeks. Chronic: >3 weeks. All ages can be affected; a study in General Practice demonstrated the highest incidence in patients aged 7-12 years. malignant external otitis. A 72-year-old patient withlong-standing Type 2 diabetes mellitus presents with complaints of pain in his right ear with purulent drainage. On physical exam, the patient is afebrile. The pinna of the left ear is tender, and the external auditory canal is swollen and edematous. The peripheral white blood cell count is. Key CT Findings in Otitis Externa. CT scan of the head is essential in diagnosing malignant necrotizing otitis externa by revealing the extent of infection into the temporal or intracranial soft tissue. CT scan of the head in cases of malignant otitis externa may reveal

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