Nasopharyngeal Inflammation from Middle Ear Infection

Epidemiology

Middle ear infection is commonly associated with cholesteatoma. Fulminanting infection involving the middle ear may be seen as a complication in patients with immunosuppression, diabetes mellitus, and malignant otitis externa.

Clinical Findings

Clinical recognition of soft tissue swelling around the external ear associated with ear discharge is indicative of the diagnosis. These patients are also frequently septic. Radiologic evaluation is requested for demonstrating the disease extent prior to treatment.

Pathology

The offending organism is usually Pseudomonas aeruginosa. The infection causes an acute osteomyelitis of the temporal bone and is termed “malignant otitis externa.” Infection involving the middle ear cleft can spread via the eustachian tube to the nasopharynx.

Treatment

Patients are treated with a combination of antibiotics, excision of infected bone, and abscess drainage.

Imaging Findings

CT