scholarly journals Developing an Algorithm for Early Diagnosis and Management of Malignant Otitis Externa

2017 ◽  
Vol 78 (S 01) ◽  
pp. S1-S156
Author(s):  
Katharine Hamlett ◽  
Jonathan Abbas ◽  
Clare Williams ◽  
Babatunde Oremule ◽  
A. Guleri ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Otitis Externa ◽  
Diagnosis And Management ◽  
Malignant Otitis Externa

Diagnostic Imaging in Malignant Otitis Externa

1982 ◽  
Vol 90 (5) ◽  
pp. 606-609 ◽  
Author(s):  
David Reiter ◽  
Larissa T. Bilaniuk ◽  
Robert A. Zimmerman
Keyword(s):  
Diagnostic Imaging ◽  
Otitis Externa ◽  
Axial Tomography ◽  
Diagnosis And Management ◽  
Malignant Otitis Externa ◽  
Computed Axial Tomography ◽  
Radionuclide Scanning

Comprehensive diagnostic imaging, including plain roentgenograms, pluridirectional tomography, computed axial tomography, and radionuclide scanning with technetium and gallium, is helpful in the diagnosis and management of malignant otitis externa. Acute and convalescent studies are presented in a successfully managed case, and guidelines are offered for employment of these studies in the management of seemingly recalcitrant 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.

Malignant Otitis Externa Resistant to Ciprofloxacin: Implications for Treatment

Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
T. Mandrali ◽  
D. Assimakopoulos ◽  
M. Karakitsou ◽  
K. Proikas ◽  
M. Tzagaroulakis
Keyword(s):  
Otitis Externa ◽  
Malignant Otitis Externa

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

Necrotising (malignant) otitis externa in the UK: a growing problem. Review of five cases and analysis of national Hospital Episode Statistics trends

2015 ◽  
Vol 129 (6) ◽  
pp. 600-603 ◽  
Author(s):  
G Chawdhary ◽  
N Liow ◽  
J Democratis ◽  
O Whiteside
Keyword(s):  
Otitis Externa ◽  
Severe Infection ◽  
Fold Increase ◽  
Antibiotic Resistant ◽  
Catchment Population ◽  
Malignant Otitis Externa ◽  
The Mean ◽  
The Uk ◽  
High Index Of Suspicion ◽  
Park Hospital

AbstractBackground:Necrotising (malignant) otitis externa is a severe infection causing temporal bone osteomyelitis. Although rare, our experience (reported herein) shows local doubling of cases in 2013. Hospital Episodes Statistics data for England over 14 years also indicate increased incidence nationally. Specific learning points in management are also discussed.Methods:A retrospective review was conducted of patients admitted in 2013 to Wexham Park Hospital, Slough, UK (catchment population, 450 000). In addition, the UK Government Hospital Episodes Statistics data were interrogated.Results:There were five cases of necrotising (malignant) otitis externa in 2013, representing a local doubling on previous years. The mean age of patients was 82 years. All cultures grew Pseudomonas aeruginosa; no isolates were antibiotic resistant. All patients responded to systemic anti-pseudomonals on clinical, biochemical and radiological parameters. Hospital Episodes Statistics data showed a six-fold increase in the number of cases from 1999 (n = 67) to 2013 (n = 421).Conclusion:Our experience suggests increasing necrotising (malignant) otitis externa incidence, and retrospective analysis of Hospital Episodes Statistics data supports this observation. Necrotising (malignant) otitis externa poses challenges in management, as exemplified in our cases, requiring a high index of suspicion and early aggressive treatment to achieve cure.

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