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[Malignant otitis externa: apropos of 19 cases]

F Rachidi-Alaoui1, L Benchekroun, A Lazrak

  • 1Hôpital des Spécialités, CHU Ibn Sina, Rabat, Maroc.

Revue De Laryngologie - Otologie - Rhinologie
|January 1, 1995
PubMed
Summary

Malignant otitis externa (MOE) in diabetic patients is a serious condition. New antibiotic treatments combined with local care offer better control, though mortality remains high.

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Diabetology

Context:

  • Malignant otitis externa (MOE) is a severe necrotizing infection of the ear canal, predominantly affecting diabetic patients.
  • This study reviews 19 cases of MOE, highlighting diagnostic criteria and treatment evolution over a 9-year period.
  • Diabetes mellitus is a significant risk factor, with MOE sometimes being the initial presentation of undiagnosed diabetes.

Purpose:

  • To analyze the clinical presentation, diagnostic methods, and treatment outcomes of malignant otitis externa in a cohort of diabetic patients.
  • To evaluate the efficacy of contemporary treatments, including new antibiotics and imaging techniques, in managing MOE.
  • To update understanding of MOE's diagnostic criteria, imaging's role, and recovery indicators based on clinical experience and literature review.

Summary:

  • The study identified otalgia and facial palsy as predominant symptoms in MOE patients, with Pseudomonas aeruginosa being the most common pathogen.
  • Computed tomography (CT) proved more effective than Tc99 scintigraphy for assessing the extent of the infection.
  • Surgical mastoidectomy is now deemed less effective than systemic antibiotic therapy, particularly with the advent of quinolones, combined with local treatments.

Impact:

  • The findings suggest a shift in MOE management towards non-surgical approaches, emphasizing systemic antibiotics and local care.
  • Improved diagnostic and treatment strategies may lead to better outcomes, although the high mortality rate of 18% underscores the severity of MOE.
  • This research provides valuable insights for clinicians regarding the diagnosis, management, and prognosis of malignant otitis externa in diabetic individuals.

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