Clinical outcome parameters for necrotizing otitis externa.
OBJECTIVE
To investigate the duration of time elapsed between the onset of symptoms for necrotizing external otitis (NEO) and admission to hospital that may play a role in patient outcome.


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Fourteen consecutive male patients with NEO with no improvement from the previous course of antibiotherapy and with findings of osteomyelitis on temporal bone CT, MRI, and positive detection of Tc-99m methylene diphosphonate on temporal bone, admitted as inpatients between 2008 and 2012.


METHODS
Medical treatment of NEO and surgical debridement.


METHODS
Patients were divided into 2 groups according to median time elapsed between onset of symptoms and hospitalization (<30 d or >30 d). HbA1c, fasting blood sugar, erythrocyte sedimentation rate, C-reactive protein, pain intensity, radiologic grade, improvement since diagnosis, and total time to cure were compared according to the groups. The relationships between the laboratory data were analyzed to determine the parameters associated with time to recovery.


RESULTS
Otalgia was significantly worse in patients who were admitted to hospital greater than 30 days after symptom onset (Mann-Whitney U test, p < 0.002). Blood glucose increased related to delayed admission time (p < 0.001). CRP results were independently elevated from the admission time (p < 0.112). There was a statistically significant difference between groups according to ESR levels and recovery time (Mann-Whitney U test, p < 0.004 and p < 0.01). There was a positive correlation between HbA1c levels and recovery time in Group 1 and between ESR levels and recovery time in Group 2 (r = 0.872, p = 0.044; r = 0.630, p = 0.039).


CONCLUSIONS
Clinical, laboratory, and outcome data worsen later than 30 days in NEO.
*Department of Otorhinolaryngology/Head and Neck Surgery, Haydarpaşa Numune Educational and Research Hospital, Istanbul; and †Department of Otorhinolaryngology/Head and Neck Surgery, Kütahya Educational and Research Hospital, Kütahya, Turkey.
Ayşegül
A
Verim
Bariş
B
Naiboğlu
Çigdem  Tepe
Ç
Karaca
Lütfü
L
Seneldir
Semra
S
Külekçi
Çağatay
Ç
Oysu
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003646:Debridement; D006801:Humans; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents