Necrotising Otitis Externa: A Review of Imaging Modalities

Abstract

Necrotising Otitis Externa (NOE) has often posed some challenges in view of diagnosis and management by clinicians. One such challenge is the appropriate and timely use of imaging techniques since its use is critical not only in diagnosis but also in determining the extent and resolution of the disease. Hence, doctors in both primary and secondary health care need to be familiar with presenting symptoms while specialists need to be appraised of advances in imagining techniques in diagnosis and management of NOE. Whilst there is a general consensus amongst clinicians on some aspects of management of NOE, there is very limited consensus on the use of imaging modalities. There is no single modality of imaging that can provide a complete picture of diagnosis, disease progression and resolution. This review aims to highlight the strengths and weaknesses of various imaging techniques used in the diagnosis and management of NOE over the years and whether a multi-modal imaging technique at particular stages of the disease may provide better management outcomes.

Pattern of Otitis Externa in ENT Outpatient Department

“…These findings are in accordance with those of Yassin et al [14] in Egypt, Rahman and Nhan et al [17] and Khan A.F.M. et al [15] in Bangladesh, Anwarullah and Jayader et al [18] in Visakhapatnam, India, and then in Myanmar [19]. Hawke et al [20] in Canada, Mungliston et al [21] in London had also shown similar incidence in male and female patients in their studies.…”

“…In our study population, the maximum number of patients were Labourer constituting 30%, who were engaged to work in hot, humid, and overcrowded places, maintaining very poor personal hygiene. Studies of Yassin et al [14] in Egypt and Khan and Rahman et al [17], and Khan A.F.M et al [15] in Bangladesh also showed Similar results while than of Myanmar had shown higher prevalence among children, school teachers, and office staff [19]. In the present study, educational status showed that only 2.5% were illiterate, and the remaining patients were literate, varying from primary education to master level.…”

“…Yassin et al [14] of Egypt, Khan and Rahman et al [17] and Khan A.F.M. et al [15] of Bangladesh, Pulsivia et al [26] of Pune, India, and Hawke et al [20] of Canada had also provided similar results in their studies. Marcy et al [27] found an incidence 10-20 times higher in the summer than during cooler months, and Roland and Stroman et al [28] of America found 80.5% cases occurred during the summer months and remained during the rest of the year.…”

“…30-36 % of the patients found otitis externa disabling enough to interrupt their daily activities, and 21% of them require bed rest [11]. Bangladeshi population is particularly vulnerable to fungal infection of the external canal [15]. The majority of our rural population enjoys a free bath in the river, canal, pond, etc., inviting water contamination.…”

Otitis externa

“…Med MRskanning kan man påvise spredning af infektion til bløddele relateret til temporalbenet, absces, flegmone og sinustrombose. PET/CT kan anvendes til at følge forløbet af sygdommen[19].…”