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Necrotising otitis externa: a serious condition becoming more frequently encountered

Published online by Cambridge University Press:  25 November 2021

A Z Eweiss ,
M Al-Aaraj ,
P Sethukumar  and
G Jama
A Z Eweiss*
Affiliation:
ENT Department, Barking Havering and Redbridge University Hospitals, London, UK ENT Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
M Al-Aaraj
Affiliation:
ENT Department, Barking Havering and Redbridge University Hospitals, London, UK
P Sethukumar
Affiliation:
ENT Department, Barking Havering and Redbridge University Hospitals, London, UK
G Jama
Affiliation:
ENT Department, Barking Havering and Redbridge University Hospitals, London, UK
*
Author for correspondence: Mr Ahmed Z Eweiss, ENT Department, Queens Hospital, Rom Valley Way, RomfordRM7 0AG, UK E-mail: azews@yahoo.com Fax: +44 1708 435 096
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Abstract

Background

Necrotising otitis externa is an aggressive infection of the external ear, which extends to the surrounding bone and soft tissue. In recent years, there has been an apparent increase in the number of patients admitted to our hospital with this condition.

Methods

A retrospective review was conducted of all patients admitted to our hospital with necrotising otitis externa between July 2012 and June 2020.

Results

Among 39 patients included, only 9 were diagnosed in the first four years, and 30 were diagnosed in the last four years. There were 27 males and 12 females, and the mean age was 78.7 years. There were six non-diabetic immunocompetent patients. Cranial nerve palsies developed in 50 per cent of the patients. Disease-related mortality was 7.7 per cent. A favourable outcome was recorded in 66.7 per cent of the patients.

Conclusion

Necrotising otitis externa is associated with high morbidity and mortality. The incidence of the disease is rising in our local geographical area.

Keywords

Otitis ExternaMalignant Otitis ExternaCranial NervesFacial NerveIncidence
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 5 , May 2022 , pp. 386 - 390
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Mr A Z Eweiss takes responsibility for the integrity of the content of the paper

References

Gonzalez, JLT, Suarez, LLR, de Leon, JEH. Malignant otitis externa: an updated review. Am J Otolaryngol 2021;42:102894CrossRefGoogle Scholar
Chandler, JR. Malignant external otitis. Laryngoscope 1968;78:1257–94CrossRefGoogle ScholarPubMed
Nadol, JB Jr. Histopathology of Pseudomonas osteomyelitis of the temporal bone starting as malignant external otitis. Am J Otolaryngol 1980;1:359–71CrossRefGoogle ScholarPubMed
Long, DA, Koyfman, A, Long, B. An emergency medicine-focused review of malignant otitis externa. Am J Emerg Med 2020;38:1671–8CrossRefGoogle ScholarPubMed
Hasnaoui, M, Mabrouk, AB, Chelli, J, Ammari, FL, Lahmar, R, Toumi, A et al. Necrotising otitis externa: a single centre experience. J Otol 2021;16:22–6CrossRefGoogle ScholarPubMed
Glikson, E, Sagiv, D, Wolf, M, Shapira, Y. Necrotising otitis externa: diagnosis, treatment and outcome in a case series. Diagn Microbiol Infect Dis 2017;87:74–8CrossRefGoogle Scholar
Shpitzer, T, Levy, R, Stern, Y, Segal, K, Cohen, O, Feinmesser, R. Malignant external otitis in nondiabetic patients. Ann Otol Rhinol Laryngol 1993;102:870–2CrossRefGoogle ScholarPubMed
Liu, X, Peng, H, Mo, T, Liang, Y. Malignant otitis externa in a healthy non-diabetic patient. Eur Arch Otorhinolaryngol 2016;273:2261–5CrossRefGoogle Scholar
Vourexakis, Z, Kos, M, Guyot, J. Atypical presentations of malignant otitis externa. J Laryngol Otol 2010;124:1205–8CrossRefGoogle ScholarPubMed
Unadkat, S, Kanzara, T, Watters, G. Necrotising otitis externa in the immunocompetent patient: case series. J Laryngol Otol 2018;132:71–4CrossRefGoogle ScholarPubMed
Cunningham, M, Yu, VL, Turner, J, Curtin, H. Necrotizing otitis externa due to aspergillus in an immunocompetent patient. Arch Otolaryngol Head Neck Surg 1988;114:554–6CrossRefGoogle Scholar
Shavit, SS, Soudry, E, Hamzany, Y, Nageris, B. Malignant external otitis: factors predicting patient outcomes. Am J Otolaryngol 2016;37:425–30CrossRefGoogle Scholar
Carfrae, MJ, Kesser, BW. Malignant otitis externa. Otolaryngol Clin North Am 2008;41:537–49CrossRefGoogle ScholarPubMed
Mani, N, Sudhoff, H, Rajagopal, S, Moffat, D, Axon, PR. Cranial nerve involvement in malignant external otitis: implications for clinical outcome. Laryngoscope 2007;117:907–10CrossRefGoogle ScholarPubMed
Bhasker, D, Hatley, A, Agada, F. Is malignant otitis externa on the increase? A retrospective review of cases. Ear Nose Throat J 2017;96:E1–5CrossRefGoogle ScholarPubMed
Chawdhary, G, Liow, N, Democratis, J, Whiteside, O. Necrotising (malignant) otitis externa in the UK: a growing problem. Review of five cases and analysis of national Hospital Episode Statistics trends. J Laryngol Otol 2015;129:600–3CrossRefGoogle ScholarPubMed