Necrotizing or malignant external otitis (MEO) also known as malignant otitis externa (MOE) is a severe invasive infection of the external auditory canal that invades the base of the skull and causes potentially life-threatening complications. MEO is often found in elderly patients with diabetes mellitus, chronic kidney disease (CKD) and kidney failure [1] [2] or other conditions that compromise the body’s immune system such as in cancer patients receiving chemotherapy and radiotherapy [3]. This case report is for an elderly deceased female patient with squamous cell carcinoma (SCC) and malignant external otitis of the left external auditory canal (EAC). The patient has a European ancestry and has lived all her life in the Kingdom of Saudi Arabia (KSA), together with her husband and their children. Although a good quality of life (QOL) was always maintained for the patient, she suffered difficult health conditions from time to time throughout her life. In this case study, a detailed report of the patient’s case is presented including her family ancestry genetic testing results in addition to a number of medical images (and analysis) via computed tomography (CT) scan and magnetic resonance imaging (MRI). It was found that the patient’s paternal ancestry is positive to the human Y-DNA haplogroup R-M198, which is found at its highest frequencies in the Central and Eastern Europe, essential to understand the causes related to the health conditions of this patient. Furthermore, the medical images from the CT scan and Brain MRI revealed detailed information of the patient’s case of MEO and SCC. CT scan revealed osteomyelitis (and extension of infection) of the temporal bone, whereas MRI was superior to CT in estimating the anatomic extent including inflammation of fat, connective tissue, muscles, bone, and cartilage.

1.
P
Evans
and
L
Hofmann
1994
Malignant External Otitis: A Case Report and Review
American Family Physician
49
2
pp
427
31
2.
S
Kumar
,
A
Ravikumar
,
L
Somu
and
N
Ismail
2012
Malignant otitis externa: An emerging scourge
Journal of Clinical Gerontology and Geriatrics
4
4
pp
128
131
3.
T
Eguchi
,
A
Basugi
,
I
Kanai
and
Y
Miyata
2018
Malignant external otitis following radiotherapy for oral cancer
Medicine Baltimore
97
21
4.
S
Pai
and
W
Westra
2009
Molecular Pathology of Head and Neck Cancer: Implications for Diagnosis, Prognosis, and Treatment
Annual Review of Pathology
4
pp
49
70
5.
Cancer.org
2019
Treating Squamous Cell Carcinoma of the Skin American Cancer Society
, [Online]. Available: https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/treating/squamousl-cell-carcinoma.html. [Accessed 22 January 2020]
6.
S.
Monga
,
A.
Sharma
,
J.
Malik
,
S.
Rasool
,
R.
Priya
and
K.
Naseeruddin
2017
Temporal Bone Carcinoma Mimicking as Malignant Otitis Externa
Global Journal of Otolaryngology Glob J Otolaryngol
9
5
7.
Lee
S. K.
,
Lee
S. A.
,
Seon
S. W.
, et al. 
2017
Analysis of Prognostic Factors in Malignant External Otitis
Clin Exp Otorhinolaryngol
10
3
pp
228
235
8.
FTDNA
2019
FTDNA FTDNA [Online]. Available: https://www.familytreedna.com/products/y-dna. [Accessed 2019]
9.
FTDNA
2019
Matches Map FTDNA 2 [Online]. [Accessed 2019]
10.
NHS UK
2014
The view from the top NHS UK
[Online]. Available: https://www.eposters.net/pdfs/the-view-from-the-top-approach-to-the-topogram-on-ct-of-the-head.pdf. [Accessed 2020]
11.
Case.edu 2016 Computed Tomography (CT) of the Brain: Basics Case.edu [Online]. Available: https://case.edu/med/neurology/NR/CT%20Basics.htm. [Accessed May 2020]
12.
Karantanas
,
G.
Karantzas
,
V.
Katsiva
,
K.
Proikas
and
V.
Sandris
2003
CT and MRI in malignant external otitis: a report of four cases
Comput Med Imaging Graph
1
27
pp
27
34
13.
Case.edu 2006 Magnetic Resonance Imaging (MRI) of the Brain and Spine: Basics Case.edu [Online]. Available
: https://casemed.case.edu/clerkships/neurology/Web%20Neurorad/MRI%20Basics.htm. [Accessed May 2020]
14.
M.
Zlatkin
2003
MRI of the shoulder
Philadelphia
:
Lippincott Williams & Wilkins
15.
M. P.
Brown
and
K.
Austin
,
The New Physique
(
Publisher Name
,
Publisher City
,
2005
), pp.
25
30
.
16.
M. P.
Brown
and
K.
Austin
,
Appl. Phys. Letters
85
,
2503
2504
(
2004
).
17.
R. T.
Wang
, “Title of Chapter,” in
Classic Physiques
, edited by
R. B.
Hamil
(
Publisher Name
,
Publisher City
,
1999
), pp.
212
213
.
18.
C. D.
Smith
and
E. F.
Jones
, “Load-cycling in cubic press,” in
Shock Compression of Condensed Matter-2001, AIP Conference Proceedings
620
, edited by
M. D.
Furnish
 et al. (
AIP Publishing
,
Melville, NY
,
2002
), pp.
651
654
.
19.
B. R.
Jackson
and
T.
Pitman
, U.S. Patent No. 6,345,224 (8 July
2004
)
20.
D. L.
Davids
, “
Recovery effects in binary aluminum alloys
,” Ph.D. thesis,
Harvard University
,
1998
.
21.
R. C.
Mikkelson
(private communication).
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