Surgical management of benign necrotizing otitis externa

1994 ◽  
Vol 108 (2) ◽  
pp. 101-105 ◽  
Author(s):  
P. J. Wordmald
Keyword(s):  
Differential Diagnosis ◽  
Surgical Management ◽  
Otitis Externa ◽  
Rare Condition ◽  
Vascular Supply ◽  
External Ear ◽  
Unknown Aetiology ◽  
Necrotizing Otitis Externa ◽  
Malignant Otitis Externa

AbstractBenign necrotizing otitis externa (BNOE) is a rare condition of unknown aetiology which is characterized by the formation of an avascular bony sequestrum of the tympanic plate. The vascular supply of the tympanic plate is easily compromized as demonstrated by the development of avascular necrosis in radionecrosis of the tympanic plate and malignant otitis externa. Recognition of BNOE as distinct from malignant otitis externa and carcinoma of the external ear is important as the treatment differs greatly. BNOE also forms an important part of the differential diagnosis of recalcitrant otitis externa.Management of BNOE has been unclear with long-term medical treatment being advocated. In this series of five patients, the surgical management of four patients with BNOE is described. Surgery was successful in all these patients and is advocated as an alternative to medical management.

Benign necrotizing osteitis of the external auditory meatus

1997 ◽  
Vol 111 (3) ◽  
pp. 269-270 ◽  
Author(s):  
B. N. Kumar ◽  
R. M. Walsh ◽  
A. Sinha ◽  
R. G. Courteney-Harris ◽  
W. V. Carlin
Keyword(s):  
Temporal Bone ◽  
Otitis Externa ◽  
Rare Condition ◽  
External Auditory Meatus ◽  
Surgical Excision ◽  
The Other ◽  
External Meatus ◽  
Malignant Otitis Externa ◽  
Benign Process

AbstractBenign necrotizing osteitis of the external auditory meatus is a rare condition which occurs in non-diabetic healthy people. The aetiology of the necrotic process with the formation of sequestrum in the bony external meatus is unknown. It is important to differentiate this benign process from malignant otitis externa and radionecrosis of the temporal bone as the management of these conditions differs. We present two cases, one managed surgically and the other medically, and review the literature. Immediate surgical excision of the sequestrum is advocated instead of long-term medical therapy and waiting for it to separate spontaneously.

The external ear

2019 ◽  
pp. 77-94
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Skin Cancer ◽  
Otitis Externa ◽  
Rare Condition ◽  
External Ear ◽  
Advantages And Disadvantages ◽  
Necrotizing Otitis Externa ◽  
Serious Infection ◽  
Patients With Diabetes ◽  
Ear Wax ◽  
Classification And Treatment

Conditions affecting the outer ear are discussed, including congenital abnormalities, infections, trauma, and malignancy. Methods of ear wax removal and their advantages and disadvantages are tabulated. Management of the serious infection of necrotizing otitis externa usually affecting patients with diabetes is outlined. Skin cancer affecting the skin of the pinna and its treatment are listed. The rare condition of carcinoma of the external auditory canal, its classification, and treatment planning are documented.

The external ear

2009 ◽  
pp. 73-88
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Otitis Externa ◽  
Congenital Abnormalities ◽  
Structure And Function ◽  
External Ear ◽  
Necrotizing Otitis Externa ◽  
And Function

Structure and function of the external ear 74 Congenital abnormalities 76 Infection of the pinna 78 Trauma to the pinna 80 Otitis externa 82 Necrotizing otitis externa 84 Malignancy of the pinna 86 Malignancy of the EAC 88 A working knowledge of the anatomy of the ear helps in documentation, correspondence, and in describing sites of lesions and trauma over the telephone. The main anatomical points are shown in ...

Osteomyelitis of the temporomandibular joint in patients with malignant otitis externa

1999 ◽  
Vol 113 (5) ◽  
pp. 451-453 ◽  
Author(s):  
Katie I. Midwinter ◽  
Kanwar S. Gill ◽  
John A. Spencer ◽  
Iain D. Fraser
Keyword(s):  
Temporomandibular Joint ◽  
Otitis Externa ◽  
Cranial Neuropathy ◽  
Diabetic Patients ◽  
High Morbidity ◽  
External Ear ◽  
Resonance Imaging ◽  
Malignant Otitis Externa ◽  
Magnetic Resonance Imaging Mri

AbstractMalignant (invasive) otitis externa is an infection involving the external ear canal, often in elderly diabetic patients, which carries a high morbidity and mortality. It may involve widespread areas of soft tissue around the skull base, and in more advanced cases, may give rise to osteomyelitis and cranial neuropathy. We describe two patients who were treated for malignant otitis externa complicated by destructive osteomyelitis of the temporomandibular joint (TMJ). For both patients, diagnosis was made using magnetic resonance imaging (MRI), and repeat scans were employed during follow-up. Improved scan appearances mirrored improvements in clinical condition in both cases.

scholarly journals Surgical Treatment of Malignant Otitis Externa MOE A New Hope Although Challenging

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Akhil Chandra Biswas
Keyword(s):  
Diabetes Mellitus ◽  
Facial Nerve ◽  
Surgical Management ◽  
Sedimentation Rate ◽  
Otitis Externa ◽  
Adequate Dose ◽  
Erythrocyte Sedimentation ◽  
Malignant Otitis Externa ◽  
Culture And Sensitivity ◽  
Serious Disease

Objective: Malignant external otitis is an aggressive inflammatory condition of the external auditory canal. Most often affects elderly patients with diabetes mellitus. This is a serious disease which spreads in the skull base associated with cranial nerve complications and high morbidity-mortality rate. Malignant otitis externa requires urgent diagnosis and treatment. The primary and most effective treatment is to control the diabetes and to fight infection with the proper antibiotic in adequate dose and duration. If medical treatment fails aggressive surgical management is the only option to save life. We present a short experience in the management of this disease. The aim of this study was to present our experience with the surgical management of malignant otitis externa. Methods: All patients' records with malignant otitis externa during the last 5 years (2007-2012) were retrieved and reviewed. Diabetes mellitus profile, erythrocyte sedimentation rate, ear swab for culture and sensitivity, computed tomography, were investigated for all patients. Results: During the last 5 years (2014-2019), 5 patients with the diagnosis of malignant otitis externa were admitted to our hospital for investigation and treatment. All between 60 and 70 years of age, with severe persistent otalgia, purulent otorrhea, granulation tissue in the external auditory canal, and diffuse external otitis, and there were 2 patients with facial nerve palsy. Patients were confirmed to have diabetes. Ear swabs for culture and sensitivity usually revealed Pseudomonas aeruginosa. One patient by systemic antibiotic and two patients were treated by Local debridement and systemic antibiotics were sufficient to control the disease. Two patients were treated by aggressive surgical debridement (skull base debridement) with 360degree Facial nerve decompression. Patients were recovered from dreadful necrotizing infection but with facial paralysis. Conclusion: Malignant otitis externa is still a serious disease associated with cranial nerve complications and high morbiditymortality rate. The primary and most effective treatment is to control the diabetes and to fight infection with the proper antibiotic in adequate dose and duration, debridement of necrotic tissue, and sometimes aggressive surgical management. Monitoring of therapy response is done through normalization of erythrocyte sedimentation rate, control of diabetes mellitus.

scholarly journals Recurrent malignant otitis externa with multiple cranial nerve involvement: A case report

2016 ◽  
Vol 144 (5-6) ◽  
pp. 315-319 ◽  
Author(s):  
Dragoslava Djeric ◽  
Miljan Folic ◽  
Milos Janicijevic ◽  
Srbislav Blazic ◽  
Danka Popadic
Keyword(s):  
Cranial Nerve ◽  
Otitis Externa ◽  
Cranial Nerves ◽  
Clinical Signs ◽  
Treatment Protocol ◽  
Illustrative Case ◽  
Lateral Sinus ◽  
Necrotizing Otitis Externa ◽  
Malignant Otitis Externa ◽  
Multiple Cranial Nerve

Introduction. Necrotizing otitis externa is a rare but conditionally fatal infection of external auditory canal with extension to deep soft tissue and bones, resulting in necrosis and osteomyelitis of the temporal bone and scull base. This condition is also known as malignant otitis due to an aggressive behavior and poor treatment response. Early diagnosis of malignant otitis is a difficult challenge. We present an illustrative case of necrotizing otitis externa and suggest some strategies to avoid diagnostic and treatment pitfalls. Case Outline. A 70-year-old patient presented with signs of malignant otitis externa, complicated by peripheral facial palsy. Adequate diagnostic and treatment procedures were performed with clinical signs of resolution. The recurrence of malignant infection had presented three months after previous infection with multiple cranial nerve neuropathies and signs of jugular vein and lateral sinus thrombosis. An aggressive antibiotic treatment and surgery were carried out, followed by substantial recovery of the patient and complete restoration of cranial nerves? functions. Conclusion. Necrotizing otitis externa is a serious condition with uncertain prognosis. The suspicion of malignant external otitis should be raised in cases of resistance to topical treatment, especially in patient with predisposing factors. Evidence-based guideline for necrotizing otitis externa still doesn?t exist and treatment protocol should be adjusted to individual presentation of each patient.

Oral focal mucinosis of the palate: a rare disease entity

2020 ◽  
Vol 13 (3) ◽  
pp. e230233
Author(s):  
Alice Cameron ◽  
James Edward Noctun Webster ◽  
Catherine Elizabeth Wicks ◽  
Serryth Dominic Colbert
Keyword(s):  
Differential Diagnosis ◽  
Hyaluronic Acid ◽  
Soft Tissue ◽  
Connective Tissue ◽  
Histological Analysis ◽  
Rare Condition ◽  
Disease Entity ◽  
Unknown Aetiology ◽  
Myxoid Degeneration ◽  
Oral Soft Tissue

Oral focal mucinosis (OFM) is an extremely rare, benign oral soft tissue condition; less than 10 documented cases have been reported in the literature in patients under 18 years old. OFM has an unknown aetiology and predominantly presents in the fourth and fifth decades. The pathogenesis of OFM may be due to fibroblast overproduction of hyaluronic acid. Clinically, it remains almost impossible to diagnose definitively, due to its lack of pathognomonic features, therefore such lesions may have multiple differential diagnoses and histological analysis is essential to confirm OFM. We present an unusual presentation of OFM in a 14-year-old female patient. Following excision, focal myxoid degeneration of the connective tissue was apparent. This case highlights this rare condition for consideration in differential diagnosis of clinically similar lesions.

Absence of toxicity in patients with malignant otitis externa following long-term treatment with high dosage tobramycin

1994 ◽  
Vol 34 (2) ◽  
pp. 267-274 ◽  
Author(s):  
L. L. Ioannides-Demos ◽  
S. C. Li ◽  
E. B. Bastone ◽  
D. W. Spelman ◽  
R. E. Hooper ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Malignant Otitis Externa

scholarly journals Necrotizing Otitis Externa: A Disease Barely Known to Neurosurgeons

2016 ◽  
Vol 38 (03) ◽  
pp. 239-245
Author(s):  
Sérgio Augusto Vieira Cançado ◽  
Lucídio Duarte de Souza ◽  
Rodrigo Moreira Faleiro ◽  
José Maurício Siqueira
Keyword(s):  
Early Diagnosis ◽  
Skull Base ◽  
Otitis Externa ◽  
Clinical Presentation ◽  
Neurological Impairment ◽  
Diabetic Patients ◽  
Necrotizing Otitis Externa ◽  
Clinical Presentations ◽  
Malignant Otitis Externa ◽  
High Index Of Suspicion

AbstractNecrotizing otitis externa (NOE), also known as malignant otitis externa (MOE), is a severe and rare infectious disease of the external auditory canal (EAC). Without treatment, it may progress to skull base involvement. The bacteria Pseudomonas aeruginosa is the most common causative agent (∼ 90% of the cases), and affects immunocompromised subjects, particularly diabetic patients. Severe chronic otalgia, otorrhea, and cranial nerve palsy are the most common clinical presentations. Patients with NOE are frequently referred to neurosurgery because of the neurological impairment and skull base compromise. The definitive diagnosis is frequently elusive, requiring a high index of suspicion. Several laboratorial tests, imaging modalities, and the histologic exclusion of malignancy may be required. An early diagnosis and aggressive treatment reduce morbidity and mortality. We present four NOE cases to illustrate the spectrum of clinical presentation and complementary exams. According to the literature, more effort for early diagnosis and treatment is required, and neurosurgeons play an important role in this task.

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