[Malignant external otitis].
Malignant external otitis or skull base osteomyelitis and osteoradionecrosis of the skull base and the skull are potentially life-threatening conditions. The standard methods of treatment involve the use of antibiotics, local treatment and, where necessary, surgical excision of necrotic tissue. These approaches do not provide a complete cure in many cases. Severe functional deficits and even death can occur in advanced stages. We conducted a long-term retrospective follow-up study and report on a multimodal approach that we have been using with great success since 1987. The four cornerstones of this treatment are surgical debridement, combinations of antibiotics, specific immunoglobulins, and adjunctive hyperbaric oxygen therapy. This multimodal treatment approach has proved to be highly effective in improving the survival and quality of life of the patients concerned. These excellent outcomes justify the high costs that this therapy admittedly involves.
Tisch
M
M
Bundeswehrkrankenhaus Ulm, Abteilung für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Chirurgie, Oberer Eselsberg 40, 89081 Ulm. matthias.tisch@hals-nasen-ohren.net
Maier
H
H
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D048909:Diabetes Complications; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation; D010019:Osteomyelitis / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D010032:Otitis Externa / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology / Q000601:surgery / Q000628:therapy; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D019291:Skull Base; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents