Central skull base osteomyelitis as a complication of necrotizing otitis externa: Imaging findings, complications, and challenges of diagnosis

Central skull base osteomyelitis is a rare, life-threatening complication of necrotizing or “malignant” otitis externa (NOE), which results in destruction of the skull base. The imaging appearances can be misinterpreted as malignancy but consideration of this diagnosis, both radiologically and clinically, is imperative to avoid the need for biopsy. The aim of this review is to highlight the pertinent imaging findings on computed tomography and magnetic resonance imaging as well as the potential complications of this condition.