title: Hyperbaric oxygenation for necrotizing (malignant) otitis externa.
abstract: Two patients with extensive necrotizing otitis externa have been treated by hyperbaric oxygenation. One patient had facial nerve palsy and the other suffered from skull base involvement. Due to severe side effects, the preferred combined intravenous antibiotic therapy was changed to monotherapy in one case and completely withdrawn in the second. This was done before the commencement of hyperbaric oxygenation, while the necrotizing infection was still active. Hyperbaric oxygenation therapy was followed by complete resolution of the necrotizing otitis externa, which did not recur. The pathogenesis of the disease and mechanisms by which hyperbaric oxygenation might be of benefit are described. We conclude that hyperbaric oxygenation should be considered as adjuvant therapy for necrotizing otitis externa whenever a therapeutic pressure chamber is available.
authors.affiliation: Department of Otolaryngology, Carmel Lady Davis Hospital, Haifa, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Shupak
authors.forename: E
authors.initials: E
authors.lastname: Greenberg
authors.forename: R
authors.initials: R
authors.lastname: Hardoff
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: Y
authors.initials: Y
authors.lastname: Melamed
authors.forename: W S
authors.initials: WS
authors.lastname: Meyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D009336:Necrosis; D010032:Otitis Externa / Q000473:pathology / Q000628:therapy*; D011552:Pseudomonas Infections / Q000473:pathology / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents