Vol. 7, Issue 8, Part D (2021)

Abstract
The purpose of this case report is to present a case of malignant otitis externa with left side Bell’s palsy, who came to my clinic for physiotherapy. He was having tenderness on the left side retroauricular area & mastoid process. The patient was also suffering from diabetes mellitus & was under medication. He was treated with galvanic stimulation for 30 sittings & demonstrated facial exercises, which he practiced in home in front of mirror. The patient also received antibiotics suggested by an E.N.T specialist. Malignant otitis externa (MOE) is a rare fatal inflammatory disease of the external auditory canal, temporal bone, and skull base. The disease is associated with serious complications with cranial nerve involvement and high mortality and morbidity rate [1]. MOE was first reported by Toulmouche in 1838, and it was termed as “malignant” by Chandler in 1968 [2, 3]. MOE is generally caused by Pseudomonas aeruginosa, and it is common in elderly patients with diabetes or immunocompromised patients [4]. Staphylococcus aureus; Proteus mirabilis; and some species of fungi, such as aspergillus and Candida species, have also been described to cause MOE [5]. Clinical manifestations of the disease are otalgia persisting for longer than one month, chronic otorrhea, headache, and cranial nerve involvement [6]. The disease begins in the external auditory canal and then spreads to the skull base through Santorini’s fissures. Additionally, the disease spreads to the stylomastoid and jugular foramina [7]. Cranial nerve involvement may occur as a result of infection progression. Facial nerve is the most common involved cranial nerve, but glossopharyngeal, vagus, accessory, or hypoglossal nerve involvements can also occur [8]. MOE is also complicated by parotitis, mastoiditis, jugular vein thrombosis, meningitis, and death [9].