PRELIMINARY-RESULTS ON SCINTIGRAPHIC EVALUATION OF MALIGNANT EXTERNALOTITIS

Malignant external otitis (MEO) is a potentially fatal otitis occurrin g in diabetic and immunosuppressed patients, which may cause cranial n erve palsies and massive thrombophlebitis of the brain. We studied fiv e diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid a nd gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves . This combined assessment helped us to diagnose and follow-up soft ti ssue and temporal bone infection, especially in the case of transsphen oidal extension of the disease, since conventional radiology and compu ted tomography were of no particular help. On the basis of these resul ts, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad ( diabetes, granuloma, and Pseudomonas aeruginosa) is not always present .