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Predicting outcome of malignant external otitis.

Ben Zion Joshua1, Jaqueline Sulkes, Eyal Raveh

  • 1Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|March 5, 2008
PubMed
Summary

Malignant external otitis (MEO) Type 1, common in older diabetics with complications, has a worse prognosis than Type 2. Early diagnosis and treatment are crucial for better outcomes in MEO patients.

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Diabetology

Background:

  • Malignant external otitis (MEO) presents diagnostic and therapeutic challenges.
  • Recent quinolone resistance necessitates updated outcome analysis.
  • No diagnostic study since 1987 highlights the need for current data.

Purpose of the Study:

  • To analyze the outcomes of Malignant external otitis (MEO) in a tertiary medical center.
  • To compare MEO Type 1 and Type 2 based on diagnostic criteria and treatment response.
  • To identify factors influencing MEO prognosis.

Main Methods:

  • Seventy-five patients with suspected MEO (1990-2003) were classified into Type 1 and Type 2.
  • Classification based on clinical, radiological criteria, and treatment response.

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  • Demographic data, comorbidities, ear findings, cultures, and treatment details were analyzed.

    • Main Results:

    • Both MEO types predominantly affected diabetic patients, presenting with ear discharge, pain, and Pseudomonas aeruginosa infection.
    • Type 1 MEO showed older age, higher rates of oral antidiabetic treatment, and diabetic complications.
    • Type 1 MEO had more extensive disease (nasopharyngeal, bone destruction, TMJ involvement), leading to longer treatment and poorer survival.

    Conclusions:

    • Type 1 Malignant external otitis (MEO) is associated with a significantly worse prognosis compared to Type 2.
    • Earlier diagnosis and prompt intervention are critical for improving outcomes in MEO patients.
    • Identifying Type 1 MEO early can guide more aggressive and timely treatment strategies.