Malignant otitis externa, a virulent disease of diabetic middle aged and elderly. Benghazi Medical Center experience.

Abstract

Malignant otitis externa is an infectious condition mainly in diabetic elderly, affects the primarily external auditory canal, and may extend causing lethal consequences. This cases series study attempts to describe characteristics, management and outcome of cases with this condition in otorhinolaryngology department in Benghazi medical center during eight years' experience from 2011 to 2019. The study included 41 patients with this diagnosis all were diabetic middle aged or elderly, none had strict control of his diabetes. Otalgia and external canal edema manifested in all cases. External auditory canal thickening, granulation tissue, bone erosion and destruction were prominent imaging features. All cases obtained management by using; aural toilet, ear wick, local antibiotics and parenteral antibiotics with only small proportion received chemotherapy. Residual seventh nerve palsy was evident among 14.63 %; with no statistically significant difference from admission figure (P > 0.05). Recurrence was reported among 21.95% of the series; with no statistically significant differences across different factors. Erythrocyte sedimentation rate had statistically significant association with recovery. Hospital stay averaged 15.3 days which is comparable with other hospitals abroad. Control of diabetes and early response to otalgia and hearing difficulty may be helpful in better outcomes. The local management policy appears satisfactory but further research may be needed.

Keyword: Malignant otitis externa, diabetic, Benghazi Medical Center, outcomes.