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Malignant external otitis: a dangerous misnomer?

F E Lucente, S C Parisier, P M Som

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |March 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    Malignant external otitis requires immediate, intensive treatment, especially in diabetic patients. Early diagnosis and aggressive therapy, including imaging and specific medications, are crucial to prevent invasive osteomyelitis.

    Area of Science:

    • Otolaryngology
    • Infectious Diseases
    • Diabetology

    Background:

    • Malignant external otitis (MEO) is a severe infection often seen in diabetic patients.
    • Diabetic patients have compromised defense mechanisms, increasing susceptibility to MEO.
    • MEO can extend beyond the ear canal, leading to invasive osteomyelitis.

    Purpose of the Study:

    • To review treatment experience with 16 MEO patients.
    • To survey compromised defense mechanisms in diabetic patients.
    • To emphasize the need for immediate and intense therapy for MEO.

    Main Methods:

    • Review of 16 patient cases with MEO.
    • Survey of diabetic patient defense mechanisms.
    • Utilized radioisotope scans, high-resolution computed tomography (CT), and multidirectional tomograms for disease delineation.

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  • Therapeutic interventions included intravenous aminoglycosides and penicillin derivatives, limited surgery, and hyperbaric oxygenation.

    • Main Results:

    • Aggressive, vigilant therapy is confirmed as essential for MEO.
    • Imaging techniques effectively delineate the extent of MEO.
    • Combined therapeutic modalities are employed for MEO treatment.

    Conclusions:

    • MEO necessitates immediate, intense, and vigilant therapeutic approaches.
    • Classifying MEO as a variant of diffuse external otitis may lead to undertreatment.
    • Prompt and comprehensive management is vital to prevent lethal complications like invasive osteomyelitis.