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[Diagnosis and therapy of the so-called malignant external otitis (author's transl)]
Abstract:
The malignant external otitis is characterized by the following symptoms: Severe neuralgic pain in the deep ear region is found in the elderly diabe-the cases with a facial palsy due to the infection of the outer ear. In more than 50 percent of the cases with a facial palsy due to the infection the further course was letal (Chandler 1968). A new surgical treatment of the malignant external otitis (Naumann 1977) is presented: After the adequate excision of all infected tissue and cartilage a perforated polyethylen-tube is placed into the infected area along the base of the skull. The combined therapy of a parenteral and local administration of antibiotics helps to improve the bad prognosis of the malignant external otitis.
Insights
Malignant external otitis, a severe ear infection, presents with deep pain and facial palsy, often leading to fatal outcomes. A new surgical approach combined with antibiotics improves the prognosis for this dangerous condition.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Surgical Oncology
Background:
- Malignant external otitis (MEO) is a severe necrotizing infection of the external auditory canal and surrounding tissues.
- It primarily affects elderly patients, particularly those with diabetes mellitus.
- MEO can lead to significant morbidity and mortality, with facial palsy being a common complication.
Observation:
- Patients present with severe neuralgic pain in the deep ear region.
- Facial palsy occurs in a significant percentage of MEO cases.
- A high mortality rate (over 50%) was previously associated with MEO complicated by facial palsy.
Findings:
- A novel surgical treatment involves the adequate excision of infected tissue and cartilage.
- A perforated polyethylene tube is inserted along the skull base into the infected area.
- Combined parenteral and local antibiotic administration is crucial.
Implications:
- This new surgical technique, alongside comprehensive antibiotic therapy, offers a promising approach to managing malignant external otitis.
- Improved treatment strategies can reduce the high mortality associated with this aggressive infection.
- Further research into MEO management is warranted to optimize patient outcomes.