Malignant otitis externa: an Australian case series.
OBJECTIVE
To establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution.


METHODS
Retrospective cohort outcomes study.


METHODS
24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I-IV. Laboratory investigations Including C-reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded.


RESULTS
Radiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001).


CONCLUSIONS
Malignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing. MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.
Royal College of Surgeons Ireland, Otolaryngology, Beaumont Hospital, Dublin, Ireland.
Ronald
R
Chin
Phoebe
P
Roche
Elizabeth
E
Sigston
Neil
N
Valance
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002097:C-Reactive Protein / Q000032:analysis; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging; D008875:Middle Aged; D010032:Otitis Externa / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D013701:Temporal Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D002097:C-Reactive Protein; D006442:Glycated Hemoglobin