CLINICAL PROPERTIES OF MALIGNANT OTITIS EXTERNA AND THE ROLE OF SURGERY IN THE TREATMENT
1İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi, KBB Kliniği, İzmir, Türkiye2Nusaybin Devlet Hastanesi, KBB Kliniği, Mardin, Türkiye Objective: To present the clinical properties and treatment outcomes of 10 consecutive cases of malignant otitis externa who were treated with local surgical debridements and parenteral antibiotherapy in our department in the last six years.
Methods: Medical records of 10 patients who were treated for malignant otitis externa in our department between 2013 ? 2019 were researched. Demographic data of the patients, existing co-morbidities, clinical presentations and findings, high resolution computed tomography findings, isolated microorganisms, antibiotherapy regimes and duration of antibiotherapy, extension of the disease, local and systemic complications, clinical courses and mortality rate were evaluated.
Results: The patients were four females and six males. The mean age was 61.5 ± 9.4 years (min.47, max.79). All cases presented with ear discharge and otalgia, which were resistant to analgesics. The most common findings in the computed tomography scans were soft tissue edema and bone necrosis, especially in the chondro-osseous junction of the external ear canal. In seven (70%) patients Pseudomonas aeruginosa, in two patients (20%) Staphylococcus aureus was the causal germ. Eight patients (80%) had cranial nerve palsy at presentation. The mean duration of treatment was 56.0 ± 31.9 days. The mortality rate was 10% (1/10).
Conclusions: Today, malignant otitis externa is still a potentially lethal disease. The main treatment is systemic antibiotherapy alongside with the treatment of existing co-morbidities. In the literature, extensive surgical interventions are discouraged. Based on our clinical experience and literature findings, we suggest that limited local surgical debridements can also be considered as interventional procedures for the treatment of MOE.
Keywords : Malignant otitis externa, treatment, surgery