Otitis externa other imaging findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.; Tarek Nafee, M.D. [2]

Overview

Other imaging findings to facilitate accurate diagnosis of malignant necrotizing otitis externa includes Technetium-99m and Gallium Citrate Ga 67 scintigraphical nuclear imaging. Tc-99m analysis will demonstrate activity of osteoblast cells that are indicative of infection from malignant otitis externa. Gallium Citrate Ga 67 scans will reveal the extent of the spread of malignant otitis externa infection by measuring the response of macrophages and reticular endothelial system in the areas of inflammation in the affected areas. Gallium Citrate Ga 67 is preferred to Technetium-99m for scintigraphic scans due to the tendency of Tc-99m to be overly sensitive to osteoblast activity, often resulting in false positive results, as well as displaying positive results after the infection is treated.

Other imaging findings

Nuclear Scintigraphy

• For malignant otitis externa, Technetium-99m-based scintigraphy will reveal the extent of the infectious damage on the temporal and intracranial bones.
  • Tc-99m analysis will display the activity of osteoblast cells that are indicative of infection from malignant otitis externa.
• Gallium Citrate Ga 67 scans will reveal extent of the spread of infection
  • The gallium citrate is absorbed by the macrophages and reticular endothelial cells in the areas of inflammation
• Gallium Citrate Ga 67 is preferred to Technetium-99m for scintigraphic scans due to the tendency of Tc-99m to be overly sensitive to osteoblast activity which results in false positive results
  • Ga 67 scans will provide more accurate findings regarding ongoing malignant otitis externa infection.