Management of malignant (necrotising) otitis externa

Hollis, Scott; Evans, Kathryn

doi:10.1017/s0022215110002550

Cited by 44 publications

(39 citation statements)

References 47 publications

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“…Radionuclide scans, such as technetium-99 m methylene disphosphonate or gallium-67 citrate, are sensitive in detecting disease activity but lack specificity. These imaging techniques were not available at our institution [6] .…”

Section: Discussionmentioning

confidence: 99%

“…There is literature to suggest that hyperbaric oxygen has a role in normalizing oxygen tension in the inflamed tissues (necessary for bacterial destruction caused by polymorphonuclear leucocytes) [6] . However, we do not have hyperbaric oxygen facilities available at our institution.…”

Section: Discussionmentioning

confidence: 99%

“…Previous literature has looked at case series of patients with necrotizing otitis externa and suggested management protocols, but these have been with relatively small numbers and have not looked at the impact of a dedicated management protocol with joint care between infectious diseases and otorhinolaryngology [6] .…”

Section: Introductionmentioning

confidence: 99%

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Management of Necrotizing Otitis Externa: Our Experience with Forty-Three Patients

2017

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OBJECTIVE:To assess the impact of the introduction of a dedicated management protocol of necrotizing otitis externa patients with joint care between otorhinolaryngology and infectious diseases. MATERIALS and METHODS:Retrospective review of case notes and the otorhinolaryngology department database of all adults admitted with necrotizing otitis externa at our teaching hospital over a 5-year period. The patients were split into two groups (first group of 10 patients prior to the introduction of the dedicated management protocol, and a second group of 33 patients managed after the introduction of this protocol). RESULTS:Of the 43 patients included in the study, diabetes mellitus was present in 83.7%. Pseudomonas aeruginosa was grown in 67.4% of patients. All 43 patients underwent computed tomography and magnetic resonance imaging (with contrast) scans. Surgical intervention was undertaken in 25.6% of patients. Mean follow-up was 10 months (SD, ±7 months). Of the 43 patients, 79.1% made a full recovery and were discharged. Relapse occurred in 9.3% of patients. One patient died because of a myocardial infarction 4 months after treatment. The mean length of stay was significantly lower after the protocol was introduced (25.6±5.3 vs. 14.2±3.8 days, p=0.001), and the duration of treatment was also significantly lower after the protocol (21.2±6.8 vs. 14.3±4.3 weeks, p=0.01). CONCLUSION:The introduction of a dedicated management protocol and joint care with otorhinolaryngology and infectious diseases resulted in improved care and decreased length of stay in patients. Early diagnosis and involvement with the relevant teams as well as prompt intervention are the key factors that reduce morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of Necrotizing Otitis Externa: Our Experience with Forty-Three Patients

2017

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“…Klinik olarak, DKK'da ağrılı, şiddetli enflamasyon, progresif pürülan akıntı ve kanalın tabanında; kemikkıkırdak bileşkesinde granülasyon dokuları görülür (1)(2)(3)(4)(5) . DKK'dan köken alan hastalık kemik-kıkırdak bileşkesinden temporal kemiğin altındaki yumuşak dokulara yayılır (6) . Tedavi edilmediği taktirde kafa tabanına yayılarak osteomiyelite ve VII.…”

Section: Introductionunclassified

“…(1)(2)(3)(4) . Başlangıç semptomları kulak ağrısı, kulakta dolgunluk, pürülan otore ve işitme kaybıdır (5)(6)(7)(8) . Konka cildinde eritem ve ödem görülebilir.…”

Section: Introductionunclassified

Malignant Otitis Externa with Facial Paralysis: A case report

Tutar¹,

Berkıten²,

Mutlu³

et al. 2016

Okmeydani Medical Journal

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The diagnostic conundrum in necrotizing otitis externa

Ahmed

Rashid

Gupta

et al. 2023

World j. otorhinolaryngol.-head neck surg.

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Necrotizing otitis externa (NOE) is an aggressive and fast‐evolving infection of the external auditory canal. Late diagnoses and untreated cases can lead to severe, even fatal consequences and so early diagnosis and treatment are paramount. NOE is a notoriously challenging diagnosis to make. It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease. This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations, thus, providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.

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Management of malignant (necrotising) otitis externa

Cited by 44 publications

References 47 publications

Management of Necrotizing Otitis Externa: Our Experience with Forty-Three Patients

Management of Necrotizing Otitis Externa: Our Experience with Forty-Three Patients

Malignant Otitis Externa with Facial Paralysis: A case report

The diagnostic conundrum in necrotizing otitis externa

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