OBJECTIVE:Malignant otitis externa (MOE) is an uncommon but potentially fatal disease of the external auditory canal. The study aimed at evaluating the demographic profile, coexisting disabilities, clinical presentations, and management of MOE MATERIALS and METHODS:This is a retrospective study of patients with MOE who were treated at the Otorhinolaryngology Department of our institution. The case records of patients treated between 2006 and 2013 for MOE were reviewed from the Medical Records Department of the hospital. The details were tabulated in a master chart, and the data were analyzed. RESULTS:Fifteen patients with MOE were treated as inpatients at the Otorhinolaryngology Department of our hospital during the study period. Of these, 12 were males and three were females. Among the 15 patients, 14 were diabetic and one was non-diabetic. Earache was the most common symptom observed in all patients; edema and granulations in the ear canal was the most common sign observed in 12 patients. Pseudomonas aeruginosa was isolated in 11 patients. All patients were managed medically with intravenous antibiotics.CONCLUSION: MOE is a rare but aggressive condition affecting the external ear, which is commonly observed in elderly diabetic individuals. Immune senescence may be the cause of MOE in elderly people. Pseudomonas is the most common causative organism isolated in this condition. Most of these patients can be managed with medical treatment; reserving surgery only for the removal of granulation tissue and for histopathological examination.
Background Malignant otitis externa is an inflammatory condition of the external ear which has the propensity to spread to the skull base. It can be a difficult entity to treat as clinical presentation varies and response to treatment differs between patients. We reviewed cases of malignant otitis externa in our setup to document the epidemiology and outcome of management. Methods This is a retrospective case review observational study from January 2013–December 2017. Fourteen patients diagnosed with malignant otitis externa in our tertiary referral centre were included in the study. Based on hospital protocol, empiric treatment was started. After discharge, the patients follow up visits to the hospital were also documented. Results Otalgia was the most common symptom. Edema and congestion of the external auditory canal were observed in most cases. Diabetes was present in all patients. Three cases had associated facial palsy, and one patient had involvement of 7th, 9th, 10th, 11th and 12 th cranial nerve. Two patients with facial palsy recovered. Pseudomonas aeuroginosa was the most common organism isolated (50%). Conclusions In our series, malignant otitis externa invariably presented with severe otalgia. Lower cranial palsies were also seen. Methods to evaluate complete eradication of disease should be centered on clinical symptoms and signs, but the measurement of erythrocyte sedimentation rate or radiological imaging may be used as a useful adjunct when there is uncertainty.
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