Malignant external otitis: management policy

1992 ◽  
Vol 106 (1) ◽  
pp. 5-6 ◽  
Author(s):  
Osama El-Silimy ◽  
M. Sharnuby
Keyword(s):  
Pseudomonas Aeruginosa ◽  
External Auditory Canal ◽  
Personal Experience ◽  
Management Policy ◽  
External Otitis ◽  
Scanning Method ◽  
Malignant External Otitis ◽  
Adjacent Structures ◽  
Nuclear Scanning

AbstractMalignant external otitis is a progressive pseudomonal infection of the external auditory canal and adjacent structures. In the literature there is no unified policy regarding the management of malignant external otitis. The development of an effective nuclear scanning method and antibiotics active against Pseudomonas aeruginosa have helped in formulating our management policy. A review of four years personal experience with this condition is presented. All of our cases were cured from the disease with no fatality. Gallium67 citrate scans showed that antipseudomonal treatment should continue for up to three months.

Malignant External Otitis: Review and Personal Experience

1996 ◽  
Vol 116 ◽  
pp. 3-16 ◽  
Author(s):  
Luca Amorosa ◽  
Giovanni Carlo Modugno ◽  
Antonio Pirodda
Keyword(s):  
Personal Experience ◽  
External Otitis ◽  
Malignant External Otitis

Malignant External Otitis: Review and Personal Experience

1996 ◽  
Vol 116 (sup521) ◽  
pp. 3-16 ◽  
Author(s):  
Luca Amorosa ◽  
Giovanni Carlo Modugno ◽  
Antonio Pirodda
Keyword(s):  
Personal Experience ◽  
External Otitis ◽  
Malignant External Otitis

Malignant External Otitis: Further Considerations

1977 ◽  
Vol 86 (4) ◽  
pp. 417-428 ◽  
Author(s):  
James R. Chandler
Keyword(s):  
External Auditory Canal ◽  
Soft Tissues ◽  
Sinus Thrombosis ◽  
External Otitis ◽  
Malignant External Otitis ◽  
Cranial Nerve Palsies ◽  
Death Experience ◽  
A Site ◽  
Base Of The Skull ◽  
Methods Of Treatment

Malignant external otitis is an infection which begins in the external auditory canal. It is uniformly caused by the Gram negative Pseudomonas aeruginosa organism and mainly affects elderly diabetics. It spreads to the soft tissues beneath the temporal bone and, if not properly treated leads to facial nerve palsy, mastoiditis, sepsis, osteomyelitis of the base of the skull, sigmoid sinus thrombosis, multiple cranial nerve palsies and death. Experience with 72 patients in varying stages of the disease is summarized. Stressed are the diagnostic criteria of nonresponsiveness to the usual methods of treatment, continued suppuration, and the continuing reformation of granulation tissue in the floor of the external auditory canal. Medical treatment is recommended with hospitalization and intravenous carbenicillin and gentamicin. Minor surgical debridement is helpful. All patients should be treated medically for as long as improvement continues, reserving surgical intervention only in the event a plateau is reached or symptoms and signs become worse under treatment. With or without a major surgical procedure, it is imperative to continue treatment for at least seven days after apparent cure in order to avoid recurrent disease possibly at a site distant from the canal.

scholarly journals NUCLEAR SCANNING IN NECROTIZING PROGRESSIVE ???MALIGNANT??? EXTERNAL OTITIS

1982 ◽  
Vol 92 (9) ◽  
pp. 1016???1020 ◽  
Author(s):  
SIMON C. PARISIER ◽  
FRANK E. LUCENTE ◽  
SHOLOM Z. HIRSCHMAN ◽  
PETER M. SOM ◽  
LEON M. ARNOLD ◽  
...  
Keyword(s):  
External Otitis ◽  
Malignant External Otitis ◽  
Nuclear Scanning

Malignant External Otitis in Nondiabetic Patients

1993 ◽  
Vol 102 (11) ◽  
pp. 870-872 ◽  
Author(s):  
Thomas Shpitzer ◽  
Rudy Levy ◽  
Yoram Stern ◽  
Karl Segal ◽  
Ohad Cohen ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Severe Pain ◽  
Medical Center ◽  
Neck Surgery ◽  
External Otitis ◽  
External Ear ◽  
Ear Canal ◽  
Significant Group ◽  
Malignant External Otitis ◽  
Pseudomonas Aeruginosa Infection

The purpose of this study is to point out that contrary to traditional belief, there is a small but significant group of nondiabetic patients with malignant external otitis. Thirty patients with a diagnosis of malignant external otitis were treated and followed up at the Department of Otolaryngology—Head and Neck Surgery, Beilinson Medical Center, between 1987 and 1991. Nine of these patients did not have clinical or laboratory evidence of diabetes. This study analyzes this group and concludes that the diagnosis of malignant external otitis should be considered by the treating physician in nondiabetic patients presenting with a Pseudomonas aeruginosa infection of the external ear canal. Severe pain and edematous closure of the canal, together with typical granulation tissue and failure to respond to medical treatment, are specific characteristics of this group.

Malignant External Otitis Due to Pseudomonas aeruginosa in Childhood

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 782-783
Author(s):  
Philip Sherman ◽  
Steven Black ◽  
Moses Grossman
Keyword(s):  
Diabetes Mellitus ◽  
Pseudomonas Aeruginosa ◽  
Body Weight ◽  
Case Report ◽  
External Otitis ◽  
External Ear ◽  
Elderly Adults ◽  
Ear Canal ◽  
Malignant External Otitis ◽  
Neurologic Sequelae

Malignant external otitis (MEO) is a severe variant of external otitis. As originally described by Chandler1 in 1968, MEO is an infection of the external ear canal, usually due to Pseudomonas aeruginosa, which is associated with systemic invasion, significant neurologic sequelae, and a high mortality rate. The vast majority of cases have occurred in elderly adults with diabetes mellitus. We present a case of MEO occurring in a 6-year-old child and have compared the findings in our case with those in the adult literature. CASE REPORT A previously well 6-year-old boy developed otitis media one month prior to admission which was treated with 5 ml of trimethoprim-sulfamethazole orally twice a day (3 mg of trimethoprim per kilogram of body weight per day).

scholarly journals Concurrent plasmablastic lymphoma with malignant external otitis in the external auditory canal

2014 ◽  
Vol 99 (793) ◽  
pp. 162-164
Author(s):  
Mª del Pilar Navarro-Paule ◽  
Raquel Redondo-Luciañez ◽  
Nuria Salas-Barrios ◽  
J. J. Sánchez-Blanco
Keyword(s):  
External Auditory Canal ◽  
Plasmablastic Lymphoma ◽  
External Otitis ◽  
Malignant External Otitis

Microflora in External Auditory Canals of Recreational Scuba-Divers and Swimmers Related to the Tropical Waterflora of a Coral Island

1993 ◽  
Vol 27 (3-4) ◽  
pp. 187-193
Author(s):  
T. Haider ◽  
R. Sommer ◽  
G. Stanek
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Water Supply ◽  
External Auditory Canal ◽  
Pathogenic Microorganisms ◽  
Lagoon Water ◽  
Scuba Divers ◽  
Tropical Coral ◽  
Coral Island ◽  
Recreational Scuba ◽  
The Tropics

Recent studies described the acute diffuse external otitis frequently observed in recreational scuba-divers and swimmers in the tropics. In this study the microflora of the external auditory canal of 90 persons was determined. Additionally, a group of 17 persons was examined before, during and at the end of a two weeks vacation on a tropical coral island as well as three months after. Further, samples from sea, lagoon water and the water supplies used for the showers were microbiologically examined. 14 different and fecultatively pathogenic microorganisms were isolated from the external auditory canals. We found a temporary colonization with those microorganisms during the two weeks. Above all Pseudomonas aeruginosa was predominant during and at the end of the vacation especially in children. Before the vacation and three months after P. aeruginosa could not be found. The samples of sea and lagoon waters did not seem to be noticeably polluted, whereas the samples of the water supply were extremely contaminated with Pseudomonas aeruginosa. It was concluded that besides indirect factors such as tropical climate and intensive exposition to water, the insufficient treatment of the water from the supply could also be a reason for the temporary microbiological colonization of the external auditory canal.

scholarly journals From Uncommon Infection to Multi-Cranial Palsy: Malignant External Otitis Insights

Dose-Response ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 155932582096391
Author(s):  
Salvatore Ferlito ◽  
Antonino Maniaci ◽  
Milena Di Luca ◽  
Calogero Grillo ◽  
Lorenzo Mannelli ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Clinical Signs ◽  
External Otitis ◽  
Bone Lesions ◽  
Nuclear Medicine Imaging ◽  
Osteoblastic Activity ◽  
Malignant External Otitis ◽  
Remission Phase ◽  
Reading Key ◽  
Base Of The Skull

Purpose: The progression of the otitic infectious process toward diseases of particular severity is often unpredictable, just as it is challenging to manage the patient over time, even after the apparent resolution of the disease. We aim to define a radiological reading key that allows us to correctly and promptly treat the disease, avoiding the possible severe complications. Methods: We conducted a retrospective study of 13 cases of basal cranial osteomyelitis (SBO) due to malignant external otitis, by the ENT Department of the University of Catania. Through a standardized approach and following the latest guidelines, we have evaluated all patients performing a standardized and personalized radiological protocol according to the stage of the patient’s pathology and modulating the treatment consequently. Results: Clinical signs have been observed such as otorrhea (100%), otalgia in 13/13 patients (100%), granulations in external auditory canal (100%), preauricular cellulitis in 9/13 patients (69%) headache 6/13 cases (46%), dysphonia 4/13 cases (31%). HRCT of the temporal bone proved useful in identifying even minimal bone lesions in 13/13 (100%) while improving MRI in vascular and nervous involvement, although in 1/13 patient with nerve palsy clinical symptomatology preceded radiological evidence. The 99mTc 3-phase planar bone scintigraphy was positive for SBO in 9/13 cases (69%) during the initial phase and, in 100% of the cases in images delayed to 2-3 hours. Subsequent checks up to 1 year, using the Ga 67 scintigraphy, excluded the presence of recurrences in 100% of patients. Conclusion: The osteomyelitis of the base of the skull is a severe complication of malignant external otitis, often not always easily diagnosed. Recurrence can occur up to 1 year after stopping therapy. Imaging techniques such as Tc and MRI are relevant for the initial diagnostic approach and the staging of the pathology and its complications. Nuclear medicine imaging plays a fundamental role in the evaluation of related osteoblastic activity, especially in the remission phase of the disease.

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