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This article has been peer reviewed. It is the authors' final version prior to publication in Delaware Medical Journal Volume 62, Issue 12, December 1990, Pages 1417-1421. © Medical Society of Delaware.


We have presented the first child in Delaware with malignant external otitis associated with IgG4 deficiency. Our patient needed three courses of intravenous antibiotics and twice required mastoidectomy, but has recovered completely following the restoration of the natural barrier between the internal and external ear, using a fascial graft from the large temporalis muscle. Some hearing deficit remains.