scholarly journals Increasing burden of necrotizing otitis externa: our experience of 38 cases

2021 ◽  
Vol 7 (5) ◽  
pp. 853
Author(s):  
Dheeraj Lambor ◽  
Kanhai R. Naik ◽  
Carnegie DeSa ◽  
Swati Lambor ◽  
Ruby Samuel
Keyword(s):  
Otitis Externa ◽  
Nerve Palsy ◽  
Clinical Presentation ◽  
Facial Nerve Palsy ◽  
Treatment Modalities ◽  
Diabetic Patients ◽  
Significant Morbidity ◽  
Necrotizing Otitis Externa ◽  
Objective Being ◽  
Antibiotic Combination

<p><strong>Background: </strong>Necrotizing otitis externa is an infection affecting immune-compromised and elderly diabetic patients resulting in complications with significant morbidity and mortality. We present our experience with this disease, along with the investigative tools and treatment modalities that benefitted most. The objective being to analyze the course of the disease and the benefit of having an institutional protocol for its management.</p><p><strong>Methods: </strong>This is a retrospective observational study on patients diagnosed with necrotizing otitis externa between 2013-2019.</p><p><strong>Results: </strong>Out of 38 patients 36 were diabetics, the commonest clinical presentation included otalgia in 37 patients, granulations in 35, facial nerve palsy in 14 and <em>Pseudomonas aeruginosa</em> was isolated in 19 patients. They were managed with multidrug combination antibiotic therapy, topical dressing and drops with 27 showing improvement.</p><p><strong>Conclusions: </strong>We recommend a diagnostic triad for NOE comprising of otalgia in an elderly diabetic patient with granulations in the external auditory canal. It is best managed by controlling diabetes, appropriate antibiotic combination, topical dressing, and sometimes surgical debridement.</p>

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.

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&lt; 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&lt; 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

Case report: facial nerve palsy, necrotising otitis externa and leishmaniasis

2015 ◽  
Vol 46 (2) ◽  
pp. 109-110
Author(s):  
Rushad Patell ◽  
Rupal Dosi ◽  
Rikin Raj ◽  
Shreyans Doshi
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy

scholarly journals Bilateral Facial Nerve Paralysis as First Presentation of Lung Cancer

2016 ◽  
Vol 9 (3) ◽  
pp. 792-795 ◽  
Author(s):  
Shadi Hamouri ◽  
Duha Al Shorafat
Keyword(s):  
Facial Nerve ◽  
Lung Adenocarcinoma ◽  
Nerve Palsy ◽  
Hematological Malignancies ◽  
Clinical Presentation ◽  
Facial Nerve Palsy ◽  
Wide Spectrum ◽  
Leptomeningeal Carcinomatosis ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis

Leptomeningeal carcinomatosis is rare, and its precise incidence is unknown. It is associated with a wide spectrum of solid and hematological malignancies. To complicate its diagnosis, the clinical presentation of leptomeningeal carcinomatosis can be variable. We report a case of a 38-year-old male with bilateral facial nerve paralysis as first presentation of lung adenocarcinoma. To our knowledge, this is the only case describing bilateral facial nerve palsy as the first and only manifestation of lung adenocarcinoma.

The child with facial nerve palsy

2021 ◽  
pp. 175573802110462
Author(s):  
Tiffanie-Marie Borg ◽  
Amy Sarah Warwick ◽  
Mas Ahmed
Keyword(s):  
Family History ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Clinical Presentation ◽  
Facial Nerve Palsy ◽  
Family Members ◽  
The Other ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Diagnosis And Management

In this article we summarise the educational aspects regarding the clinical presentation, diagnosis and management of children presenting with facial nerve paralysis, highlighting the importance of family history. We report two cases of hereditary facial nerve paralysis managed by the authors: one a child with familial facial nerve palsy, and the other a child with Melkersson–Rosenthal syndrome. The history in both cases revealed multiple family members with the same disorder.

Fungal necrotizing otitis externa in diabetic patients: Clinical features and diagnostic difficulties

2020 ◽  
Author(s):  
Meherzi Abir ◽  
Amal Kdissa ◽  
Mouna Khalifa ◽  
Monia Ghamam ◽  
Mouna Bellakhdhar ◽  
...  
Keyword(s):  
Clinical Features ◽  
Otitis Externa ◽  
Diabetic Patients ◽  
Necrotizing Otitis Externa ◽  
Diagnostic Difficulties

Malignant Otitis Externa (MOE) causing cerebral abscess and facial nerve palsy

2010 ◽  
Vol 5 (7) ◽  
pp. E6-E8 ◽  
Author(s):  
John Roberts ◽  
Línea Larson-Williams ◽  
Farrah Ibrahim ◽  
Ali Hassoun
Keyword(s):  
Facial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Cerebral Abscess ◽  
Malignant Otitis Externa

scholarly journals Facial nerve palsy as an unusual presentation of orbital apex syndrome

2021 ◽  
Vol 17 (2) ◽  
pp. 176-179
Author(s):  
Rafiqahmed Abdulkarim Vasiwala ◽  
◽  
Wong Zhen Yu ◽  
Tee Chen Giap ◽  
Ashiya Rafiq ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Multidisciplinary Approach ◽  
Facial Nerve Palsy ◽  
Unusual Presentation ◽  
Diabetic Patients ◽  
Fungal Sinusitis ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Diagnostic Challenge

Clinical cases of orbital apex syndrome are rare and most commonly manifested as a complication of fungal sinusitis, mainly in immunocompromised and poorly controlled diabetic patients. Rhino-orbital mucormycosis is a rare opportunistic, aggressive and fatal infection caused by mucor. The complex presentation of orbital apex syndrome not only poses a diagnostic challenge but also demands a multidisciplinary approach in patient management. Facial nerve palsy is an unusual presentation in orbital apex syndrome. We report the case of a 64-year-old diabetic patient presenting with ophthalmoplegia and visual loss associated with facial nerve palsy. Prompt ophthalmologic and otolaryngologic intervention with imaging and histologic confirmation, followed by early initiation of antifungal and antimicrobial therapy, were integral to preventing further complications, and reducing morbidity and mortality.

scholarly journals A Case Series of Malignant Otitis Externa Mimicking Malignancy

2021 ◽  
Vol 64 (1) ◽  
pp. 36-41
Author(s):  
Vengathajalam Selvamalar ◽  
Nik Adilah Nik Othman ◽  
Mohd Khairi Daud
Keyword(s):  
Cranial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Case Series ◽  
Lower Cranial Nerve ◽  
Cortical Mastoidectomy ◽  
Cranial Nerve Palsies ◽  
Adjacent Structures ◽  
Malignant Otitis Externa

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

scholarly journals The Efficacy of Low-Level Laser Therapy in the Treatment of Bell’s Palsy in Diabetic Patients

2020 ◽  
Vol 11 (3) ◽  
pp. 310-315 ◽  
Author(s):  
Dawood Aghamohamdi ◽  
Solmaz Fakhari ◽  
Mehdi Farhoudi ◽  
Haleh Farzin
Keyword(s):  
Diabetes Mellitus ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Bell’S Palsy ◽  
Low Level Laser Therapy ◽  
Diabetic Patients ◽  
Bell's Palsy ◽  
Low Level ◽  
Low Level Laser ◽  
Level Laser

Introduction: The most common causes of the abrupt onset of unilateral facial weakness are stroke and Bell’s palsy. The drug regimen together with electrical stimulation was more effective in treating Bell’s palsy than conventional drug treatment alone. We aimed to evaluate more effective and safe therapies for the treatment of Bell’s palsy. Methods: This clinical interventional study was conducted on 30 diabetic patients with Bell’s palsy who referred to a pain clinic for 1 year and were treated by low-level laser (LLL). The system of House-Brackmann was used for assessing the severity of nerve damage and patients were evaluated by electromyography and nerve conduction study (NCS) before and after treatment with low-level laser. These patients had not consumed any other medication for facial nerve palsy. Results: In the present study, 30 cases with poorly controlled diabetes mellitus (18 females and 12 males) were studied. After 12 sessions of low-level laser therapy (LLLT), we could observe complete recovery in 18 patients and partial recovery in 6 patients after 3 months. Conclusion: The recovery rate showed that LLLT is a safe, reliable and proper alternative approach for the treatment of facial nerve palsy, especially in the presence of underlying conditions such as diabetes mellitus.

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