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Hyperbaric oxygen therapy in malignant otitis externa: a retrospective analysis.

Pedro Marques Gomes1, Diogo Cunha Cabral2, Joana Borges Costa2

  • 1Department of Otorhinolaryngology, Unidade Local de Saúde de Matosinhos, Hospital Pedro Hispano, Rua de Santo António, Lote 14, São Pedro do Sul, Porto, Portugal. pedrommarquesgomes@hotmail.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|May 20, 2024
PubMed
Summary

Hyperbaric oxygen therapy (HBOT) shows promise for treating malignant otitis externa (MOE), a serious ear infection. All patients in this study achieved successful outcomes with HBOT as an adjunct treatment.

Keywords:
Hyperbaric oxygenMalignant otitis externaNecrotizing otitis externaOsteomyelitis

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Hyperbaric Medicine

Background:

  • Malignant otitis externa (MOE) is a severe invasive osteomyelitis of the external ear canal, often caused by Pseudomonas aeruginosa.
  • It predominantly affects immunocompromised individuals, with diagnosis being clinical and initial treatment involving systemic antibiotics or antifungals.
  • Surgery is typically reserved for cases refractory to medical management, and specific guidelines for MOE, particularly regarding hyperbaric oxygen therapy (HBOT), are lacking.

Purpose of the Study:

  • To evaluate the clinical data, treatment protocols, and outcomes of patients diagnosed with MOE who received HBOT.
  • To assess the efficacy of HBOT as an adjuvant therapy for malignant otitis externa.

Main Methods:

  • A retrospective study was conducted at Pedro Hispano Hospital from 2007 to 2022.
  • Clinical data from fifteen patients diagnosed with MOE and treated with HBOT were analyzed.
  • Patient data included prior treatments, such as antibiotics, antifungals, and surgical interventions.

Main Results:

  • Fifteen patients with MOE were treated with HBOT during the study period.
  • All patients received concurrent antibiotic and/or antifungal therapy.
  • Three patients underwent surgical intervention prior to commencing HBOT, and all fifteen patients achieved successful management of their condition.

Conclusions:

  • HBOT appears to be a potentially effective adjuvant treatment for malignant otitis externa.
  • While robust scientific evidence is limited, the positive outcomes and minimal adverse effects observed in this retrospective study warrant consideration of HBOT's therapeutic value.
  • Further research and specific guidelines are needed to fully establish HBOT's role in MOE management.