The disease occurs without exception in elderly diabetics. Pseudomonas aeruginosa (pyocyaneus) is always found in the secretion. In our reported case of a 71-year old man appeared in addition to a fetid, festering, granulating otitis externa, disturbances of swallowing, hoarseness and severe occipital headaches appear after five months. Neurologically, the N. glossopharyngeus, the N. recurrens and the N. hypoglossus were shown to be paretic. The inflammatory process has pushed forward via the bone of the auditory meatus on to the base of the skull to the jugular foramen and the foramen lacerum. Surgical removal of the inflammatory changes and subsequent treatment with carbenicillin is recommended as the treatment of choice.