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Otitis externa: management of the recalcitrant case
1Department of Otolaryngology, Cornell University Medical College--New York Hospital, NY 10021, USA.
The American Journal of Otology
|May 1, 1994
Summary
Recalcitrant otitis externa, often severe, affects immunocompromised individuals and those with local factors or painful topical treatments. Successful management requires understanding anatomy, microbiology, and varied therapeutic options.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Immunology
Background:
- Otitis externa typically responds to standard treatment.
- A subset of patients develops severe, recalcitrant otitis externa.
- Risk factors include immunocompromise, local factors, and treatment noncompliance.
Purpose of the Study:
- To review the management of recalcitrant otitis externa.
- To highlight patient populations at risk for severe disease.
- To emphasize the importance of understanding anatomy, microbiology, and treatment options.
Main Methods:
- Literature review of otitis externa pathophysiology and treatment.
- Analysis of risk factors contributing to treatment resistance.
- Discussion of topical and systemic therapeutic modalities.
Main Results:
- Immunocompromised patients (e.g., AIDS, transplant recipients, diabetics) are at higher risk.
- Local factors like dermatitis and irradiation exacerbate the condition.
- Painful topical therapy can lead to noncompliance and treatment failure.
Conclusions:
- Successful treatment necessitates a comprehensive understanding of the external auditory canal.
- Knowledge of microbiology and pathophysiology is crucial for effective intervention.
- A review of available topical and systemic treatments is essential for managing resistant cases.