Malignant otitis externa: an Australian case series.

Area of Science:

• Otolaryngology
• Infectious Diseases
• Endocrinology

Background:

• Malignant otitis externa (MOE) is a severe necrotizing infection of the external auditory canal.
• It primarily affects elderly patients, often with diabetes mellitus.
• Establishing a clinicopathological profile is crucial for understanding disease management.

Purpose of the Study:

• To define the clinicopathological characteristics of malignant otitis externa (MOE).
• To evaluate the utility of a radiological grading system in predicting treatment duration.
• To assess the role of inflammatory markers and glycemic control in MOE patients.

Main Methods:

• Retrospective cohort study of 24 patients diagnosed with MOE between 1998 and 2007.
• Patients were classified using a radiological grading system (Grades I-IV).
• Laboratory data including C-reactive protein (CRP), white cell count (WCC), HbA1c, and average glucose levels were analyzed.

Main Results:

• Radiological grade positively correlated with the duration of therapy (r=0.57, p=0.004).
• C-reactive protein (CRP) effectively indicated disease resolution.
• Diabetic patients with MOE exhibited elevated blood glucose and poor glycemic control (HbA1c).

Conclusions:

• Malignant otitis externa (MOE) requires a multidisciplinary team approach for optimal management.
• A radiological grading system aids in predicting therapy duration and resource allocation.
• Poorly controlled diabetes is a significant risk factor for MOE, suggesting a 'brittle diabetic' subgroup.
• CRP, alongside clinical and radiological findings, is valuable for monitoring disease resolution.