Abstract: Objective To outline and analyze the clinical features and treatment option of cervical osteomyelitis secondary to necrotizing otitis externa. Methods We performed a retrospective review, along with literature review, of a case of C2-C6 osteomyelitis secondary to a necrotizing otitis externa in a diabetic patient, in order to outline its clinical manifestation, diagnosis, treatment option and prognosis. Results A total of five relevant studies published in Chinese and English from 2005 to 2022 were reviewed, and four cases(including the case presented in this study)were analyzed. The four cases involved three men and one woman(age range: 54-72 years). Only one patient had a history of head and neck radiotherapy, the remaining three were known diabetic patients. The lesions were extensive, involving two to five vertebral bodies. The causative pathogens isolated were all bacteria; however, the strains varied among the cases. After a systematic treatment, three patients(75%)succumbed to the disease as a result of bacterial resistance, poor compliance to medications, and severe comorbidity. Conclusion The lesions of necrotizing otitis externa can extend from the skull base to the cervical vertebrae, causing cervical osteomyelitis: a life-threatening condition that requires an aggressive treatment.

Key words: Necrotizing otitis externa, Osteomyelitis, Diabetes, Cervical vertebrae