title: Current management of necrotising otitis externa in the UK: survey of 221 UK otolaryngologists.
abstract: BACKGROUND
  Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making. This survey aims to report the experience of 221 otolaryngologists in this condition.
  
  
  METHODS
  Internet survey administered to the membership of the British Association of Otorhinolaryngology - Head and Neck Surgery (ENT UK).
  
  
  RESULTS
  Respondents' detailed replies on diagnosis, treatment and follow up are presented. One third of respondents reported increasing incidence of NOE. Over 80% diagnosed NOE based on pre-existing risk factors, severe pain, non-resolution of infection and CT scan. Most respondents managed NOE with intravenous antibiotics (90%) and blood sugar control (82%). There was less agreement in certain aspects of management including the role of surgery and the nature and duration of follow up.
  
  
  CONCLUSIONS
  Our survey provides a picture of NOE management in the UK. While there is consensus in some aspects of NOE management, other aspects attract widely differing answers. This may reflect the lack of strong evidence in the literature. Future work should aim to address this.
authors.affiliation: a Department of Otolaryngology , Milton Keynes University Hospital , Milton Keynes, UK.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Chawdhary
authors.affiliation: b ENT Department , Rotherham District General Hospital , Rotherham , UK.
authors.forename: Miran
authors.initials: M
authors.lastname: Pankhania
authors.affiliation: b ENT Department , Rotherham District General Hospital , Rotherham , UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Douglas
authors.affiliation: c Department of ENT , John Radcliffe Hospital , Oxford, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Bottrill
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000628:therapy; D004431:Ear, External / Q000473:pathology; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data; D015994:Incidence; D009336:Necrosis; D010032:Otitis Externa / Q000175:diagnosis / Q000628:therapy*; D000072220:Otolaryngologists; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D013396:Suction / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents
keywords: Otitis externa; diagnosis; osteomyelitis; skull base; surveys and questionnaires; therapy