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The evolving treatment of necrotizing external otitis

1988; Wiley; Volume: 98; Issue: 9 Linguagem: Inglês

10.1288/00005537-198809000-00006

1531-4995

Dennis H. Kraus, Susan J. Rehm, Sam E. Kinney,

Otolaryngology and Infectious Diseases

Necrotizing external otitis, or malignant external otitis, as initially described by Chandler, is a life-threatening Pseudomonas infection of the external auditory canal and skull base, which occurs most commonly in elderly diabetic patients. Historically, radical surgical intervention was the primary method of treatment. The treatment of choice has shifted during the past 20 years to aggressive systemic antibiotic therapy, with surgery reserved for those patients whose disease is resistant to medical therapy. Using this approach, 19 patients with necrotizing external otitis were treated at the Cleveland Clinic Foundation during the past 8 years. A 90% rate of cure was obtained. The diagnostic approach to patients suspected of having necrotizing external otitis, a classification scheme defining the extent of disease, delivery of systemic antibiotic therapy, indications for surgical intervention, and overall effectiveness of treatment are reviewed.