Recurrent Necrotizing External Otitis: Medical vs Surgical Treatment

Abstract

Necrotizing (malignant) external otitis (NEO) is a fulminant skull base osteomyelitis that appears to follow a minor episode of external otitis. The present study aimed to evaluate the outcome of medical and surgical treatment in recurrent cases. Eleven patients attending the otorhinolaryngology Department, Misrata Cancer Center were included. They had recurrence of external otitis over a period of 6 months after-cure, as well as severe night otalgia and high ESR level. Peri-auricular soft tissue swelling, trismus and cranial nerve paralysis were the main persistent or developing presentations in recurrent cases. Extensive surgical intervention was performed in two patients with unsatisfactory outcome. On the other hand, satisfactory results were obtained with those who treated with specific medical therapy after culture and sensitivity test and those who underwent minimal surgical intervention. In conclusion, NEO is an aggressive disease that necessitates controlling the blood sugar vigorously and also appropriate antibiotics, the surgical intervention is reserved only for those patients with poor response to medical treatment or complications.