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Malignant (necrotizing) externa otitis: the experience of a single hyperbaric centre
Carla Espiney Amaro1, Raquel Espiney2, Lucian Radu3
1Centro de Medicina Subaquática e Hiperbárica de Lisboa, Lisbon, Portugal. dicacarla@hotmail.com.
Summary
Hyperbaric oxygen therapy (HBOT) shows promise as an effective adjunctive treatment for malignant otitis externa (MOE), particularly in severe cases. This study found HBOT to be well-tolerated and helpful in patient recovery.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Hyperbaric Medicine
Background:
- Malignant otitis externa (MOE) is a severe, potentially fatal soft tissue infection of the external ear.
- MOE can rapidly progress to involve the skull base, requiring aggressive treatment.
- Hyperbaric oxygen treatment (HBOT) has been debated as a therapeutic option for MOE.
Purpose of the Study:
- To evaluate the effectiveness of HBOT as an adjunctive therapy for malignant otitis externa.
- To assess the tolerability and outcomes of HBOT in MOE patients.
Main Methods:
- Retrospective observational study of 16 patients with MOE treated with HBOT.
- Disease staging based on a clinicopathological classification system.
- Analysis of patient outcomes, including nerve palsy, hospitalization duration, and disease resolution.
Main Results:
- Most patients presented with advanced disease (stage 4: 53%).
- Significant rates of cranial nerve palsy (VII nerve: 43.75%, multiple nerves: 18.75%) were observed.
- HBOT was well-tolerated, with a shorter duration from HBOT initiation to cure compared to prior hospitalization (p=0.028). No fatalities occurred.
Conclusions:
- HBOT is a safe and beneficial adjunctive treatment for malignant otitis externa.
- HBOT should be considered for patients with MOE who have failed conventional therapies or present with severe disease.
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