Patients’ experience of necrotising otitis externa: a qualitative study

Abstract

Background Necrotising otitis externa is a serious infective condition. Patients are typically frail, diagnostic delay is common and severe pain is a key feature. This study aimed to qualitatively analyse patient-centred data to identify key themes in the patient's experience. Methods Open-ended questionnaires were sent to 28 patients. Responses were qualitatively analysed using a grounded theory approach. Iterative cycles were used to develop codes using a constant comparison technique. Emerging categories were refined to identify core themes. Results Four main themes emerged: severe pain, mental health, quality of life and diagnostic delays. Conclusion This is the first study to explore patients’ perspectives in necrotising otitis externa. It indicates a need to raise awareness of necrotising otitis externa, and to improve symptom management, pain control and quality of life. This valuable information can be used to identify research priorities, guide service improvements, improve clinical care and feed into the development of a Core Outcome Set for necrotising otitis externa.

A systematic review of antimicrobial treatment regimens and their outcomes in necrotising otitis externa

“…1 The first report of necrotising otitis externa appears in the literature in 1830, 2 with the first case series described by Chandler in 1968. 3 Necrotising otitis externa has a profound effect on patients' quality of life 4 and carries potentially fatal complications. 5 Necrotising otitis externa has attracted considerable interest from researchers due to its apparent rising incidence between 2002 and 2018 6 with theories for this phenomenon including increasing prevalence of diabetes mellitus, 7 antibiotic resistance, 8,9 ageing population, and increased clinician awareness of the condition.…”

Qualitative Research Methodology and Applications: A Primer for the Otolaryngologist

“…Typically, this involves 20–30 subjects to achieve data saturation, although this can certainly vary with subject matter 7,17 . Otolaryngology example: What are the factors that contribute to the low quality of life [theory] in patients with necrotizing otitis externa [relevant group]? 18 …”

Immunosuppression, infection, and epidermal compromise: an aetiological triad for necrotising otitis externa that highlights potential modifiable risk factors

“…4 Necrotising otitis externa tends to present at a late stage of the disease 3 and can have a profound negative impact on patients’ quality of life. 5…”

“…4 Necrotising otitis externa tends to present at a late stage of the disease 3 and can have a profound negative impact on patients' quality of life. 5 Clinical features of necrotising otitis externa include pain, discharge and granulation tissue arising from the ear canal floor. 6 The condition presents almost exclusively in immunocompromised patients, classically in older adult diabetic patients, and it is increasingly recognised in patients with other forms of immunocompromisation.…”