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Mortality of malignant otitis externa: A prevalence meta-analysis
Adham A Aljariri1, Ahmad R Al-Qudimat2, Rani Hammoud1
1Otolaryngology Department, Ambulatory Care Center (ACC), Hamad Medical Corporation (HMC), Doha, Qatar.
Qatar Medical Journal
|August 6, 2025
Summary
Malignant otitis externa (MOE) has an 18% mortality rate, with diabetes and hypertension worsening outcomes. Early diagnosis and targeted interventions are crucial for improving survival in MOE patients.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Epidemiology
Background:
- Malignant otitis externa (MOE) is a severe skull base infection, predominantly caused by Pseudomonas.
- Treatment has evolved from surgical to primarily medical antimicrobial therapy, though surgery may still be indicated.
- Global data on MOE prevalence and mortality are needed to establish treatment benchmarks.
Purpose of the Study:
- To determine the global prevalence and mortality rates of Malignant Otitis Externa (MOE).
- To identify key comorbidities and etiological factors associated with MOE outcomes.
- To provide data for establishing treatment benchmarks for MOE.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Searches of Scopus and PubMed databases for MOE mortality studies published between 1994 and 2022.
- Inclusion of studies reporting MOE, mortality, and data across all genders.
Main Results:
- Analysis of 22 studies with 9,633 MOE patients revealed an 18% pooled mortality prevalence.
- High prevalence of comorbidities: 57.1% diabetes, 51% hypertension.
- Pseudomonas aeruginosa was the most common pathogen (30%); cranial nerve involvement occurred in 9% of patients.
Conclusions:
- MOE presents a significant 18% global mortality risk, exacerbated by comorbidities like diabetes and hypertension.
- Despite treatment advances, substantial mortality and morbidity persist, necessitating improved management strategies.
- Early diagnosis, targeted interventions, and addressing comorbidities are vital for enhancing patient survival in MOE.
