Characteristics and prognosis of malignant external otitis with facial paralysis.

Objective: To compare the characteristics and prognosis of patients with malignant (necrotizing) external otitis (MEO) with and without facial nerve palsy in today's era of third-generation antibiotics.

Design: Comparative retrospective case series.

Setting: Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, a tertiary care medical center.

Patients: Forty-eight patients with MEO diagnosed and treated from 1990 to 2004. Eight had facial paralysis and 40 had normal facial nerve function.

Main Outcome Measures: Clinical, laboratory, and imaging findings and survival.

Results: There was no statistically significant difference between patients with and without facial nerve involvement in terms of age, comorbidities, duration of complaints, physical findings, erythrocyte sedimentation rate, and bone scan findings. Computed tomography indicated a more progressive disease in patients with facial nerve involvement. However, no statistically significant between-group difference was found in overall survival.

Conclusion: Although facial nerve involvement is a sign of progression of MEO, it does not, by itself, worsen prognosis.