Abstract
The aim of our prospective study is to illustrate the role of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis and delineation of the extent of disease in malignant external otitis (MEO) at presentation and following successful treatment. The study was performed at Tertiary academic referral center. We included 18 patients (16 males and 2 females; age, 49–79 years; mean, 65.3 years) with a clinical diagnosis of MEO in this study. CT and MRI were performed at presentation. Follow-up CT and MRI were performed after 6 and 12 months in 12 successfully treated patients. The main outcomes are CT scan and MRI findings. Results show that all patients were known to have diabetes mellitus. We present the patients’ demographic and clinical data. All patients received local treatment as well as the intravenous 3rd generation antibiotic cephalosporin for at least 6 weeks. The detailed radiological findings were reported. In conclusion, MEO is predominantly a disease of diabetic males and MEO can be managed by the control of diabetes, local treatment, and intravenous antibiotics for a long period. CT and MRI play complementary roles in the diagnosis and follow-up of patients with MEO. The extension of the disease before treatment and its disappearance from the involved areas are usually characteristic.
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References
Grandis RJ, Branstetter BF, Yu VL (2004) The changing face of malignant (necrotizing) external otitis: clinical, radiological and anatomic correlation. Lancet Infect Dis 4:34–39
Chandler J (1968) Malignant external otitis. Laryngoscope 78:1257
Hariga I, Mardassi A, Belhaj Younes F et al (2010) Necrotizing otitis externa: 19 cases’ report. Eur Arch Otorhinolaryngol 267:1193–1198
Handzel O, Halperin D (2003) Necrotizing (malignant) external otitis. Am Fam Physician 68:309–312
Carfrae MJ, Kesser BW (2008) Malignant otitis externa. Otolaryngol Clin North Am 41:537–549
Sreepada GS, Kwartler JA (2003) Skull base osteomyelitis secondary to malignant otitis externa. Curr Opin Otolaryngol Head Neck Surg 11:316–323
Arnold R, Baylin G (1959) Destructive lesions of the temporal bone. Laryngoscope 69(6):766–788
Nadol JB (1980) Histopathology of pseudomonas osteomyelitis of the temporal bone starting as malignant external otitis. Am J Otolaryngol 1:359–371
Kohut RI, Lindsay JR (1979) Necrotizing (“malignant”) external otitis: histopathologic processes. Ann Otol Rhinol Laryngol 88:714–720
Amorosa L, Modugno GC, Pirodda A (1996) Malignant external otitis: review and personal experience. Acta Otolaryngol Suppl 521:3–16
Soudry E, Joshua BZ, Sulkes J, Nageris BI (2007) Characteristics and prognosis of malignant external otitis with facial paralysis. Arch Otolaryngol Head Neck Surg 133(10):1002–1004
Joshua BZ, Sulkes J, Raveh E, Bishara J, Nageris BI (2008) Predicting outcome of malignant external otitis. Otol Neurotol 29:339–343
Mani N, Sudhoff H, Rajagopal S, Moffat D, Axon PR (2007) Cranial nerve involvement in malignant external otitis: implications for clinical outcome. Laryngoscope 117(5):907–910
Ali T, Meade K, Anari S, ElBadawey MR, Zammit-Maempel I (2010) Malignant otitis externa: case series. J Laryngol Otol 124:846–851
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The authors declare that they have neither conflict of interest nor financial relationship with the organization that sponsored the research.
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Al-Noury, K., Lotfy, A. Computed tomography and magnetic resonance imaging findings before and after treatment of patients with malignant external otitis. Eur Arch Otorhinolaryngol 268, 1727–1734 (2011). https://doi.org/10.1007/s00405-011-1552-8
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DOI: https://doi.org/10.1007/s00405-011-1552-8