The association between radiological spreading pattern and clinical outcomes in necrotizing external otitis

Area of Science:

• Infectious Diseases
• Neurology
• Radiology

Background:

• Necrotizing external otitis (NEO) is a rare but severe infectious disease affecting the skull base.
• Understanding the relationship between infectious spread patterns and clinical outcomes is crucial for patient management.

Purpose of the Study:

• To investigate the correlation between different infectious spread patterns in NEO and patient clinical outcomes.
• To determine if radiological findings can predict the severity and progression of NEO.

Main Methods:

• Retrospective chart review of 41 NEO patients from 2010-2019.
• Patients were categorized into single (Group A) or complex (Group B) spreading patterns based on CT scans.
• Clinical data, including symptoms, delays, complications, and treatment duration, were collected.

Main Results:

• Complex spread patterns (Group B) were associated with significantly higher rates of cranial nerve VII and IX palsies.
• Complications and longer antibiotic use were linked to complex spread patterns and diagnostic delay.
• Disease-related mortality was 12.2% overall, with no significant difference between groups.

Conclusions:

• Radiological spread patterns in NEO can help predict clinical outcomes.
• Complex NEO spread is associated with increased neurological deficits, complications, and treatment duration.
• Diagnostic delay is a critical factor linked to mortality, complications, and facial palsies.