Abstract: Objective To explore the diagnosis and treatment features of necrotizing otitis externa. Methods We retrospectively analyzed the clinical data of 18 patients(20 ears)with necrotizing otitis externa including clinical features, diagnosis, treatment and prognosis. Results Among the 18 patients, 10 were male and 8 were female, with unilateral onset in 16 cases and bilateral onset in 2 cases. Typical clinical features were ear pain, otorrhea and hearing loss. Four cases developed facial paralysis of varying degrees. Imaging examinations indicated bone destruction of the external auditory canal in 15 cases, and extensive involvement of the skull base was observed in 4 severe cases. The clinical staging was based on clinical manifestations and imaging features. This group of cases included 14 cased of Kraus stage Ⅰ, 2 cases of Kraus stage Ⅱ and 2 cases of Kraus stage Ⅲ. 12 patients were treated by medication and 6 patients underwent surgical management. The anti-infective therapy was continued for 2 months after the patients discharge from the hospital and followed up for more than 1 year. One case recurred after 10 months, another one recurred in the contralateral ear after 6 months and a patient passed away 5 months later, while the rest of patients recovered successfully. Conclusion Necrotizing otitis externa should be actively treated with comorbidities. The main treatment is anti-infection. For those who have been treated with unsatisfactory results, serious conditions or severe complications, timely surgical intervention is recommended. A good prognosis can mostly be achieved, while those with skull base or intracranial involvement have a poor prognosis.

Key words: Necrotizing otitis externa, Skull base osteomyelitis, Malignant otitis externa, Clinical Diagnosis and Treatment, Prognosis