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Evidence of skull base osteomyelitis in CT and MRI: A: coronal and axial CT Scan, decreased pneumatization of mastoid air cells and Bilateral petrous and clival sclerosis indicating otomastoiditis. B: T2‐weighted axial MRI, Edema and effusion is noted in left middle ear and bilateral mastoid air cells with enhancement after iv contrast

Evidence of skull base osteomyelitis in CT and MRI: A: coronal and axial CT Scan, decreased pneumatization of mastoid air cells and Bilateral petrous and clival sclerosis indicating otomastoiditis. B: T2‐weighted axial MRI, Edema and effusion is noted in left middle ear and bilateral mastoid air cells with enhancement after iv contrast

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Skull base osteomyelitis is a rare but dangerous consequence of untreated malignant otitis externa. Pseudomonas aeruginosa is responsible for most cases with typical presentation. Here, we discuss a diabetic 54‐year‐old female presented with malignant otitis externa and bilateral facial paresis followed by cervical spondylitis and C1‐C2 instability...