Malignant External Otitis (Necrotizing Otitis Externa; Skull Base Osteomyelitis) By Bradley W Kesser, MD, University of Virginia School of Medicine Reviewed / Revised Apr 2022 | Modified Sep 2022 View Patient Education Diagnosis Treatment Malignant external otitis, also referred to as skull base osteomyelitis or necrotizing otitis externa, is typically a Pseudomonas osteomyelitis of the temporal bone.