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in subtemporal soft tissue. According to Doroghazi et a16 patients with multiple lower cranial nerve palsies usually have bone erosion around the jugular foramen which suggests that palsies of lower cranial nerves, apart from VII, are due to osteomyelitis of the skull base or to an associated extradural abscess or petrosal sinus thrombosis. According to Mendelson et al, ' Tc99 and Ga6l scans are the most helpful radiological investigations in the diagnosis of invasive external otitis, computed tomography is useful for diagnosing and assessing soft-tissue extension, and Ga67 scans are best for following resolution of infection. The Tc99 bone scan in our patient supported the possibility of osteomyelitis, the plain radio-graphs, tomograms and CT scans having shown no evidence of bone infection. Patients with multiple lower cranial nerve palsies may require detailed inves-tigation to establish a diagnosis. Pseudomonas infection of the petrous bone and skull base is a curable condition which should be considered particularly if pain is a prominent feature and if there has been evidence of recent otitis externa or mas-toiditis. AHV SCHAPIRA