Necrotising otitis externa: A serious condition becoming more frequently encountered

Eweiss, Ahmed; Al-Aaraj, Mahmoud; Sethukumar, Priya; Jama, Guled M

doi:10.1017/s0022215121003029

Cited by 2 publications

(5 citation statements)

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“…The facial nerve is often involved. Sigmoid sinus involvement causes retrograde thrombophlebitis [ 3 , 7 ]. Intracranial extension results in the involvement of opposite skull bases [ 1 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The average age of the population under our study was 58 years in contrast to other studies that reported between 67-83 years [ 2 - 4 ]. Eweiss et al, in their study, concluded that aging was no longer a factor for its incidence [ 3 ]. Excruciating ear pain was the most troublesome symptom, similar to other studies.…”

Section: Discussionmentioning

confidence: 99%

“…Malignant otitis externa (MOE) is a misnomer since it is not a neoplastic process [ 1 ]. It implies an aggressive inflammation of the external auditory canal in elderly diabetic, and immunocompromised individuals with Pseudomonas aeruginosa as the main culprit followed by methicillin-resistant Staphylococcus aureus and other fungal organisms [ 2 , 3 ]. The inflammatory process is so fierce that it may involve the skull base leading to Skull Base Osteomyelitis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…It implies an aggressive inflammation of the external auditory canal in elderly diabetic, and immunocompromised individuals with Pseudomonas aeruginosa as the main culprit followed by methicillin-resistant Staphylococcus aureus and other fungal organisms [ 2 , 3 ]. The inflammatory process is so fierce that it may involve the skull base leading to Skull Base Osteomyelitis [ 3 ]. The sequelae of this catastrophic condition can result in facial nerve palsy in adjunction to other lower cranial nerve palsies leading to deterioration in the quality of life [ 4 - 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Spectrum and Treatment Response of Malignant Otitis Externa Patients: A Rural Tertiary Care Centre Experience

Ausekar,

Prasad,

Babu

et al. 2023

Cureus

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Introduction: Malignant otitis externa (MOE) is an invasive external ear infection that has a tendency to spread through the temporal bone and can further progress to involve intracranial structures. Though the prevalence of MOE is rare, high morbidity and mortality are often associated. Complications of advanced MOE include cranial nerve involvement, most commonly facial nerve, and intracranial infections such as abscesses and meningitis. Materials and methods: In this retrospective case series of nine patients diagnosed with MOE, demographic data, clinical presentations, laboratory data, and radiological findings were reviewed. All patients were followed up for a minimum period of three months after discharge. Outcomes were measured in terms of reduction in obnoxious ear pain (Visual Analogue Scale), ear discharge, tinnitus, need for re-hospitalization, recurrence of disease, and overall survival. Results: In our case series of nine patients (seven males and two females), six underwent surgery, and three patients were managed with a medical line of treatment. All patients had a significant reduction in otorrhea, otalgia, random venous blood sugars, and improvement of facial palsy implicating good response to treatment. Conclusion: Prompt diagnosis of MOE warrants clinical expertise and aids in preventing complications. A prolonged course of intravenous anti-microbial agents is the mainstay of treatment, but timely surgical interventions in treatment-resistant cases can prevent complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Spectrum and Treatment Response of Malignant Otitis Externa Patients: A Rural Tertiary Care Centre Experience

Ausekar,

Prasad,

Babu

et al. 2023

Cureus

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show abstract

“…1 Although rare, epidemiological data shows a sharp increase in cases. 2,3 The etiologic agent classically described is Pseudomonas aeruginosa. 4 However, in recent years, there has been an increase in cases caused by other pathogens, both bacterial and fungal.…”

Section: Introductionmentioning

confidence: 99%

Necrotizing Otitis Externa: A Proposal for Diagnostic and Therapeutic Approach

Costa,

Onishi

2023

Int Arch Otorhinolaryngol

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Introduction Necrotizing otitis externa has a high impact on the quality of life of patients and has shown a significant increase in its incidence in recent years. There has been a change in the profile of affected patients and a lack of consensus on the management of these patients. Objective To develop a practical and effective care protocol to standardize the diagnostic and therapeutic management of necrotizing otitis externa. Methods A retrospective cohort study of necrotizing otitis externa patients between January 2015 and December 2020. Results There were 34 patients with two bilateral cases, totaling 36 ears. The mean age was 68.5, with a higher prevalence of males (76%). Diabetes was present in 97% of the samples. The involvement of cranial pairs was identified in 35% of the sample. Pseudomonas aeruginosa was the most frequent pathogen isolated, found in 50% of the cases. Among the cultures with bacterial agents isolated, 35% showed resistance to ciprofloxacin. The most frequent exam was computed tomography (94%). Hospital admission was indicated for 31 patients (91%), and ceftazidime was the most prescribed drug (35.5%). There were 11 recurrences (32%), and 12 patients (35%) had complications during treatment. Among the unfavorable outcomes, 12% persisted with some degree of peripheral facial paralysis, 6% maintained dysphagia, and 9% died of the disease. Conclusions The present study developed a diagnostic and therapeutic protocol for the effective management of necrotizing otitis externa. This protocol is a dynamic tool and should be revised and updated as new demands emerge during its implementation.

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Necrotising otitis externa: A serious condition becoming more frequently encountered

Cited by 2 publications

References 0 publications

Clinical Spectrum and Treatment Response of Malignant Otitis Externa Patients: A Rural Tertiary Care Centre Experience

Clinical Spectrum and Treatment Response of Malignant Otitis Externa Patients: A Rural Tertiary Care Centre Experience

Necrotizing Otitis Externa: A Proposal for Diagnostic and Therapeutic Approach

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