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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
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.
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.
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