"Technetium-99m bone scanning is sensitive to osteoblastic activity and is highly sensitive for bony infection, with uptake in the temporal bone and skull base differentiating necrotising otitis externa from typical acute otitis externa 4."
"Pseudomonas aeruginosa is the pathogen in 98% of cases. The route by which the infection spreads is variable. It can spread anteroinferiorly to involve the suprahyoid neck spaces (parotid space and masticator space). Alternatively, the infection can also erode the cartilaginous-bone of the external auditory canal resulting in a direct intracranial spread with resultant serious intracranial complications."
"Follow up imaging using gallium-67 citrate and indium-111 labelled leucocyte scans, in addition to serum ESR levels can gauge treatment response 4."
"Necrotising otitis externa may be associated with inflammatory changes within adjacent structures such as the periauricular soft tissues, nasopharynx and parapharyngeal space. Additionally there may be opacification of the mastoid air cells and middle ear from direct extension 5."