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Necrotising otitis externa: clinical profile and management protocol

Published online by Cambridge University Press:  29 October 2013

D V Lambor ,
C P Das ,
H C Goel ,
M Tiwari ,
S D Lambor  and
M V Fegade
D V Lambor*
Affiliation:
Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India
C P Das
Affiliation:
Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India
H C Goel
Affiliation:
Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India
M Tiwari
Affiliation:
Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India
S D Lambor
Affiliation:
Department of Ear, Nose, Throat and Head and Neck Surgery, Goa Medical College and Hospital, India
M V Fegade
Affiliation:
Department of Pharmacology, Goa Medical College and Hospital, India
*
Address for correspondence: Dr D V Lambor, Department of ENT, Goa Medical College, Bambolim, Goa, India-403202 E-mail: drdheerajlambor@rediffmail.com
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Abstract

Background:

Necrotising otitis externa, which is typically seen in elderly diabetics, is a severe infective disorder caused by Pseudomonas aeruginosa. There is lack of standard management policy for necrotising otitis externa, hence this study attempted to frame a protocol for management based on clinical parameters.

Method:

A retrospective study of 27 patients with necrotising otitis externa was conducted over 6 years in a tertiary care hospital. Data were analysed with regards to demographic characteristics, clinical features, investigations, staging and treatment modalities.

Results:

Out of 27 patients, 26 were diabetics. The commonest organism isolated was P aeruginosa, which was sensitive to third generation cephalosporins and fluoroquinolones. Nine patients had cranial nerve involvement. Twelve of 15 patients treated with medical therapy recovered, as did 11 of 12 patients that underwent surgery.

Conclusion:

A high index of suspicion, early diagnosis and prompt intervention are key factors to decrease morbidity and mortality. Fluoroquinolones, third generation cephalosporins and surgical debridement are the mainstay of treatment.

Keywords

Otitis ExternaFluoroquinolonesOsteomyelitisTemporal BonePseudomonasCeftazidime
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 11 , November 2013 , pp. 1071 - 1077
Copyright
Copyright © JLO (1984) Limited 2013 

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