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Endoscopic Cholesteatoma Surgery
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Necrotising otitis externa: clinical profile and management protocol.

D V Lambor1, C P Das, H C Goel

  • 1Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India.

The Journal of Laryngology and Otology
|October 31, 2013
PubMed
Summary

Necrotising otitis externa, a severe Pseudomonas aeruginosa infection in diabetics, requires prompt intervention. Early diagnosis and treatment with fluoroquinolones, cephalosporins, or surgery improve outcomes.

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Diabetology

Background:

  • Necrotising otitis externa (NOE) is a severe Pseudomonas aeruginosa infection primarily affecting elderly diabetics.
  • A lack of standardized management protocols for NOE necessitates the development of clinical guidelines.

Purpose of the Study:

  • To establish a management protocol for necrotising otitis externa based on clinical parameters.
  • To analyze demographic, clinical, and treatment data for NOE patients.

Main Methods:

  • Retrospective analysis of 27 patients diagnosed with NOE over six years.
  • Evaluation of patient demographics, clinical presentations, investigations, staging, and treatment modalities.

Main Results:

  • 26 out of 27 patients had diabetes mellitus.
  • Pseudomonas aeruginosa was the most common pathogen, sensitive to third-generation cephalosporins and fluoroquinolones.
  • Medical therapy achieved recovery in 12/15 patients, while surgery was successful in 11/12 patients.

Conclusions:

  • High index of suspicion, early diagnosis, and prompt intervention are crucial for reducing NOE morbidity and mortality.
  • Fluoroquinolones, third-generation cephalosporins, and surgical debridement form the cornerstone of NOE treatment.