Malignant otitis externa (MOE) describes an invasive, locally destructive infection rather than a malignancy. It starts in the external auditory canal and progresses to skull base osteomyelitis. Although our understanding of the pathogenesis and management of the disease has become clearer since first described five decades ago, MOE can still lead to cranial nerve palsy/-ies and eventually death.
We present an interesting case of MOE which proved to be very difficult to control despite aggressive treatment and close monitoring. The relevant literature was thoroughly reviewed. This case highlights the dilemma surrounding the ability to predict the course of the disease.