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[Malignant or necrotizing otitis externa: experience in 22 cases].

J Martel1, J Y Duclos, V Darrouzet

  • 1Service d'ORL et de chirurgie cervico-faciale, Service de médecine nucléaire, Hôpital Pellegrin C.H.U. de Bordeaux, 33076 Bordeaux Cedex.

Annales D'Oto-Laryngologie Et De Chirurgie Cervico Faciale : Bulletin De La Societe D'Oto-Laryngologie Des Hopitaux De Paris
|November 21, 2000
PubMed
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Malignant otitis externa, a severe external auditory canal infection, primarily affects diabetics and is often caused by Pseudomonas aeruginosa. Effective medical treatment, including antibiotics and hyperbaric oxygen, yields high cure rates with low recurrence.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Malignant otitis externa (MOE) is a rare but serious infection of the external auditory canal.
  • It predominantly affects elderly patients with diabetes mellitus and immunocompromised individuals.

Observation:

  • A study of 22 MOE patients revealed 60% had diabetes and 13% were immunocompromised.
  • Pseudomonas aeruginosa was identified as the causative agent in 87% of cases.
  • Computed tomography (CT) and technetium scintigraphy were crucial for diagnosis and staging.

Findings:

  • Gallium scintigraphy effectively monitored treatment response.
  • Medical management, including parenteral antibiotics (ceftazidime, ceftriaxone, ciprofloxacin, ofloxacin) and hyperbaric oxygen, achieved a 95% cure rate.

Related Experiment Videos

  • Surgery is generally not indicated for malignant otitis externa, with recurrence rates around 10%.

    • Implications:

    • This study highlights the importance of prompt diagnosis and aggressive medical management for MOE.
    • The findings support a non-surgical approach for MOE, emphasizing the efficacy of combined antibiotic and hyperbaric oxygen therapy.
    • Further research into risk factors and optimal treatment strategies for MOE is warranted.