Malignant otitis externa hospitalizations: Analysis of patient characteristics

Abstract

2C. Laryngoscope, 127:2328-2336, 2017.

A population‐based time trend study in the incidence of malignant otitis externa

“…Several hypotheses have been put forth as to the pathophysiology of MOE in patients of advanced age, including poor microcirculation and slow epithelial migration in the external ear canal, which are also associated with diabetic complications. Interestingly, 27.8% of MOE cases are comorbid with hypertension, which is in line with other reports (ranging 52.5%‐76%) . The association between hypertension and MOE requires further investigation.…”

“…The survival rate significantly improved after the introduction of ciprofloxacin and other antimicrobials in the 1990s . In our studies, we found a 2.6% in‐hospital mortality rate, while other larger series reported mortality ranging from 0.5% to 3.7% …”

“…This study is also the first to show an epidemiological study of an Asian population. In the published literature, Sylvester et al reported 8300 cases of MOE among 7 million hospitalisations per year in the US between 2002 and 2013, while Hatch et al reported 786 cases of MOE using a database covering about 30% of inpatient medical care in the US during a 3‐year time span (2012‐2015). A population‐based study conducted in Spain in 2008‐2013 also reported 355 cases of MOE, with an overall incidence of 0.13 per 100 000 cases .…”

“…However, due to the difficulty in its diagnosis and the low incidence of MOE, most studies are derived from scattered case series. There are only a handful of epidemiological studies of MOE, and those studies are limited to Caucasian populations from North America and Europe . To our knowledge, there are no epidemiological studies regarding the incidence of MOE in an Asian population.…”

Cotton bud in external ear canal causing necrotising otitis externa and subdural abscess

“…Although uncommon, NOE has been described in relatively young individuals without diabetes or immunocompromise 13. In fact, the description of NOE as a disease of exclusively older people with diabetes may not be true: between 2002 and 2013, elderly, diabetic patients accounted for only 22.7% of NOE cases 14. The incidence of NOE also appears to be increasing, with a sixfold increase in the number of cases from 1999 to 2013 15…”