Malignant Otitis Externa

Carfrae, Matthew J.; Kesser, Bradley W.

doi:10.1016/j.otc.2008.01.004

Cited by 210 publications

(270 citation statements)

References 53 publications

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“…Pseudomonas aeruginosa is the most commonly involved microorganism. Earache is usually the presenting symptom, but headache can be the predominant feature in some atypical cases [3]. We present here the findings of a 99m Tc MDP planar bone scan and SPECT/CT in a case of skull base osteomyelitis.…”

Section: Introductionmentioning

confidence: 91%

SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

Damle

Kumar

et al. 2011

Nucl Med Mol Imaging

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Skull base osteomyelitis is a potentially fatal disease. We demonstrate here the utility of SPECT/CT in diagnosing this entity, which was not obvious on a planar bone scan. A 99m Tc MDP bone scan with SPECT/CT was carried out on a patient with clinically suspected skull base osteomyelitis. Findings were correlated with contrastenhanced CT (CECT) and MRI. Planar images were equivocal, but SPECT/CT showed intense uptake in the body of sphenoid and petrous temporal bone as well as the atlas corresponding to irregular bone destruction on CT and MRI. These findings indicate that SPECT/CT may have an additional role beyond planar imaging in the detection of skull base osteomyelitis.

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Section: Introductionmentioning

confidence: 91%

SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

Damle

Kumar

et al. 2011

Nucl Med Mol Imaging

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“…Diabetics are predisposed to developing MOE due to occurrence of microangiopathy and hypoperfusion [27]. The normal host immune defences are altered in immunocompromised individuals like Diabetics.…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Unlike the normal inflammatory response of local vasodilation, vasoconstriction is seen in diabetics due to underlying endothelial dysfunction. These factors coupled with defective chemotaxis, adherence, phagocytosis, and intracellular killing result in a prolongation of the disease process [27][28][29]. Another contributing factor reported has been reduction in effectiveness of cerumen produced by Diabetics as an antimicrobial agent due to increased pH of the cerumen and reduced lysozyme content [30].…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Strict glycaemic control, correction of electrolyte imbalance, improvement in immunocompetence, aural toileting, hyperbaric oxygen therapy and prolonged systemic and ototopic antimicrobial therapy (3-6 weeks) has become crucial in effective treatment of MOE [14,27].…”

Section: Treatmentmentioning

confidence: 99%

“…Initial antibiotic of choice are antipseudomonal Penicillins like Piperacillin with Tazobactam and Fluoroquinolones like Ciprofloxacin [27].…”

Section: Treatmentmentioning

confidence: 99%

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Malignant Otitis Externa-A Review

S¹

2014

J Infect Dis Ther

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Objective: To review the literature about Malignant Otitis Externa. Methodology:A comprehensive review of existing knowledge that is available in literature has been summarised in this article.Results: There is a rising incidence of Malignant Otitis Externa in the developing countries, predominantly seen in elderly diabetics. The common organism isolated is Pseudomonas aeruginosa though other microbials have been described as a causative agent. Radioimaging such as Technitium 99m MDP Scintigraphy, Gallium 67 Single Photon Emission CT and Tc99m Sulesomab scan has been recently used to asses and monitor therapy. The treatment protocol involves initial management with intravenous antimicrobials, regular aural toileting with adjunctive Hyperbaric Oxygen therapy. Unresponsive patients require either a trial with antifungals or a tissue diagnosis to rule out other differentials. Surgery is no longer found to be a first line treatment of MOE. Conclusion:Malignant Otitis Externa is a highly fatal, necrotizing condition of the external auditory canal and temporal bone which is seen in elderly immunocompromised individuals. It is a highly aggressive skull base infection that is associated with high morbidity/mortality and cranial nerve complications. Although a variety of organisms such as Proteus mirabilis, Staphylococci, Klebsiella species and Aspergillus fumigatus have been implicated in the pathogenesis of MOE, Pseudomonas aeruginosa has been a predominant organism closely associated with MOE. With the advent of present day radiological imaging and effective antimicrobials coupled with a high index of suspicion, the mortality rate has been reduced from an alarming 50% to 20% over the past few decades.

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Dermatoses of the External Ear

Kennedy

2016

Rook's Textbook of Dermatology, Ninth Edition

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The complex embryological origin of the external ear explains developmental anomalies and some hearing abnormalities. The structure of the pinna, a cartilaginous framework beneath thin skin, contributes to some of these conditions, such as chondrodermatitis nodularis and pseudocyst of the auricle. Ear piercing has complications that present to the dermatologist. External otitis, particularly when chronic, is often multifactorial, reflecting the special environment of the skin of the ear canal. The pinna is sometimes the site of predilection for systemic diseases, such as alcaptonuria, leprosy and relapsing polychondritis. The pinna is a sun‐exposed site where squamous carcinoma is often more aggressive than when it arises at sites nearby.

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Malignant Otitis Externa

Cited by 210 publications

References 53 publications

SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

SPECT/CT in the Diagnosis of Skull Base Osteomyelitis

Malignant Otitis Externa-A Review

Dermatoses of the External Ear

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