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Malignant external otitis

X Dubernard, J-C Kleiber, E Brenet, M-A Louges, Y Veleine, M Labrousse, M Makeieff, A Bazin, A Chays
Any cutaneous lesion of the outer ear must be managed jointly by a dermatologist and an ENT, regardless of the age of the patient. The presence of a malignant cutaneous carcinoma (Squamous cell carcinoma or melanoma) of the pavilion requires a minimum extension assessment by a cervical ultrasound, CT-scan and MRI will be prescribed according to the degree of infiltration and the presence of clinics signs (lymphadenopathy, facial paralysis, cognitive impairment). A polyp of the external auditory meatus must be systematically biopsied in consultation and, if necessary, in the operating room with fresh anatomopathological analysis...
November 2017: La Presse Médicale
Daniel A Carlton, Enrique E Perez, Eric E Smouha
IMPORTANCE: Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat. OBJECTIVE: Determine if there has been a shift in the microbiology and outcomes of MEO. DESIGN: A retrospective case series at a tertiary care institution. SETTING: Inpatient and outpatient tertiary care hospital. PARTICIPANTS: 12 cases of recent MEO were reviewed...
January 2018: American Journal of Otolaryngology
Tamás Németh, László Szakács, Zsolt Bella, Valéria Majoros, Pál Barzó, Erika Vörös
Background We report a case of bilateral malignant otitis externa complicated with bilateral petrous internal carotid artery pseudoaneurysms and their successful treatment with a flow diverter. Case report A 68-year-old woman with serious complications of type II diabetes mellitus had malignant otitis externa on the right side. She was treated with combined antibiotic therapy and underwent mastoidectomy for mastoiditis. She presented at our hospital with acute hemorrhage from the right external auditory canal...
December 2017: Interventional Neuroradiology
Ho Yee Sun, Raymond K Tsang
No abstract text is available yet for this article.
December 2017: Clinical Otolaryngology
Mehrdad Hasibi, Mohammadtaghi Khorsandi Ashtiani, Masoud Motassadi Zarandi, Nasrin Yazdani, Pedram Borghei, Ali Kuhi, Sasan Dabiri, Reza Hosseini, Sara Sardashti
AIMS: High rates of negative microbiologic test results highlight the potential role of empiric antimicrobial agents in management of malignant otitis externa (MOE). This study investigates the clinical presentation, laboratory findings, and response to empiric treatment in a large group of patients admitted to a tertiary academic hospital in Tehran, Iran. METHODS AND MATERIALS: We recruited 224 patients diagnosed with MOE in a prospective observation from 2009 through 2015...
July 2017: Annals of Otology, Rhinology, and Laryngology
G N Nikiforova, V M Svistushkin, A E Shevchik, A V Zolotova
The objective of the present study was to elucidate the specific features of the clinical course of malignant externa otitis in the context of the present-day concepts. A total of 5 patients presenting with the confirmed diagnosis of malignant external otitis were available for the examination. The analysis of the clinical observations provided the basis for the characteristic of pathogenesis of this condition, diagnostic principles, and treatment modalities for the management of the pathology in question. It is concluded that the patients suffering from malignant externa otitis must remain under medical care and observation during a long period and the strategy for the treatment of each concrete patient should be chosen on an individual basis taking into consideration the presence of concomitant pathologies and their adequate therapy...
2017: Vestnik Otorinolaringologii
Cristina Conde-Díaz, Jara Llenas-García, Mónica Parra Grande, Gertrudis Terol Esclapez, Mar Masiá, Félix Gutiérrez
BACKGROUND: Skull base osteomyelitis is an uncommon disease that usually complicates a malignant external otitis with temporal bone involvement. It affects predominantly diabetic and immunocompromised males and has a high mortality rate. Pseudomonas aeruginosa is the most common causative organism. Currently, there is no consensus about the best therapeutic option. Here we describe a case of severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin...
February 21, 2017: Journal of Medical Case Reports
Sang Kuk Lee, Se A Lee, Sang Woo Seon, Jae Hyun Jung, Jong Dae Lee, Jae Young Choi, Bo Gyung Kim
OBJECTIVES: Malignant external otitis (MEO) is a potentially fatal infection of the external auditory canal, temporal bone, and skull base. Despite treatment with modern antibiotics, MEO can lead to skull base osteomyelitis. Until now, there have been few studies on the prognostic factors of MEO. METHODS: We performed a retrospective study to identify prognostic factors of MEO, and a meta-analysis of other articles investigating MEO. On the basis of disease progression the 28 patients in our study were divided into 'controlled' and 'uncontrolled' groups, consisting of 12 and 16 patients, respectively...
September 2017: Clinical and Experimental Otorhinolaryngology
Oliver McLaren, Christian Potter
A 79-year-old man, with a history of well-controlled diabetes mellitus, presented with left-sided otalgia. With an initial diagnosis of simple otitis externa, he was discharged on topical drops. He represented 2 months later with worsening otalgia and discharge. A diagnosis of malignant otitis externa was made based on clinical and radiological findings. Intravenous Tazocin and Gentamicin were given based on previous bacterial culture from ear swabs. The patient failed to improve and developed left-sided facial nerve palsy...
September 9, 2016: BMJ Case Reports
Sagit Stern Shavit, Ethan Soudry, Yaniv Hamzany, Ben Nageris
OBJECTIVE: Malignant external otitis (MEO) is an aggressive infection, primarily affecting elderly diabetic patients. It begins in the external ear canal and spreads to adjacent structures. This study investigated the clinical characteristics of patients diagnosed and treated for MEO and analyzed factors affecting patient outcomes. STUDY DESIGN: Historical cohort. SETTING: Tertiary medical center. METHODS: Medical records of all patients diagnosed and treated for MEO from 1990 to 2013, were retrospectively reviewed...
September 2016: American Journal of Otolaryngology
Antonio Guerrero-Espejo, Inmaculada Valenciano-Moreno, Rafael Ramírez-Llorens, Palmira Pérez-Monteagudo
INTRODUCTION: Malignant external otitis is a necrotizing infection, which extends from the squamous epithelium of the ear canal to the adjacent tissue. The objective of the study was to investigate its incidence and other epidemiological data in Spain, reporting the largest case series to date. METHODS: A descriptive, retrospective study of the Spanish population was carried out using the minimum basic data set (MBDS) based on data of patients admitted to hospitals in the 2008-2013 period...
January 2017: Acta Otorrinolaringológica Española
M Mion, R Bovo, R Marchese-Ragona, A Martini
The aim of this review is to summarise literature data on clinical aspects and traditional management of fungal malignant external otitis (FMEO), and to identify potential predictive factors of positive treatment outcome. Articles were initially selected based on their titles or abstracts. Full articles were then retrieved and further scrutinised according to predetermined criteria. Reference lists of selected articles were searched for any missed publications. The selected articles were methodologically evaluated...
October 2015: Acta Otorhinolaryngologica Italica
S T Exarchos, V A Lachanas, S Tsiouvaka, E Kapsalaki, J G Bizakis
BACKGROUND: Ipsilateral hypoglossal nerve (XII) paresis has never been reported as the first and only complication of malignant otitis external (MOE). CASE REPORT: A 73-year-old diabetic male with persistent left temporomandibular joint ache and ear fullness was admitted with the diagnosis of MOE. He received intravenous ciprofloxacin for 14 days and then continued with oral administration (per os). After two months, he returned with otalgia, swallowing difficulty, and ipsilateral XII paresis...
2015: B-ENT
Suck-Chul Lee, Jae-Hyung Kim, Chul-Hoon Kim, Bok-Joo Kim
Skull-base osteomyelitis is a rare disease affecting the medulla of the temporal, sphenoid, and occipital bones. In general, it occurs due to external ear canal infections caused by malignant external otitis. Skull-base osteomyelitis usually affects elderly diabetic patients. The patient, a 58-year-old man, was referred for evaluation and management of the left jaw. Clinical examination of the patient revealed pain in the left jaw and mouth-opening deflection to the left. The maximum active mouth opening was measured to about 27 mm...
December 2015: Maxillofacial Plastic and Reconstructive Surgery
Yushi Ueki, Hiroshi Matsuyama, Yuka Morita, Kuniyuki Takahashi, Yutaka Yamamoto, Sugata Takahashi
Typical osteomyelitis is reportedly caused by Pseudomonous aeruginosa in elderly diabetic patients after malignant external otitis. Recently, complications have arisen due to the emergence of atypical osteomyelitis. We have experiensed 5 cases of skull base osteomyelitis at our hospital. All patients were male with a mean age of 75.2 years. Four patients had diabetes. Regarding the clinical and radiographic findings, patients 1, 2, and 3 had typical osteomyelitis after malignant external otitis, whereas patients 4 and 5 had atypical osteomyelitis without temporal bone findings...
January 2015: Nihon Jibiinkoka Gakkai Kaiho
Karolina Dorobisz, Marzena Kubacka, Krzysztof Zub, Tadeusz Dorobisz, Marzena Janczak, Anna Roszkowska, Tomasz Zatoński, Tomasz Kręcicki, Marcin Frączek
Squamous cell carcinoma of the external auditory canal is a very rare and unusual malignancy, representing less than 0.2% of all head and neck cancers. The authors present a case of 78-year-old patient with bilateral squamous cell carcinoma of the external auditory canal-cT4N0M0 G2, pT4N2bM0, initially treated as a chronic otitis external. The patient was qualifies for the one-step removal of cancer of the earlobe and the external auditory canal. Because of complications during the operation, the plan of treatment was changed...
August 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Xiao-Long Liu, Hong Peng, Ting-Ting Mo, Yong Liang
A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function...
August 2016: European Archives of Oto-rhino-laryngology
Vadisha Bhat, Ajaz Aziz, Satheesh Kumar Bhandary, Rajeshwary Aroor, Shrinath D Kamath P, Marina Saldanha
OBJECTIVE: Malignant otitis externa (MOE) is an uncommon but potentially fatal disease of the external auditory canal. The study aimed at evaluating the demographic profile, coexisting disabilities, clinical presentations, and management of MOE. MATERIALS AND METHODS: This is a retrospective study of patients with MOE who were treated at the Otorhinolaryngology Department of our institution. The case records of patients treated between 2006 and 2013 for MOE were reviewed from the Medical Records Department of the hospital...
April 2015: Journal of International Advanced Otology
J Manuel Sarmiento, Andrew S Venteicher, Chirag G Patil
BACKGROUND: In most people with low-grade gliomas (LGG), the primary treatment regimen remains a combination of surgery followed by postoperative radiotherapy. However, the optimal timing of radiotherapy is controversial. It is unclear whether to use radiotherapy in the early postoperative period, or whether radiotherapy should be delayed until tumour progression occurs. OBJECTIVES: To assess the effects of early postoperative radiotherapy versus radiotherapy delayed until tumour progression for low-grade intracranial gliomas in people who had initial biopsy or surgical resection...
June 29, 2015: Cochrane Database of Systematic Reviews
X Zhang, S Bai, H Li, H Hu, X Duan, M Chen, D Wang, Y Chen, F Zhang, J Shen
OBJECTIVE: To summarize the radiological and clinical features of radiation-induced external auditory canal carcinomas (RIEACCs) in patients with nasopharyngeal carcinomas (NPCs) after radiation therapy. METHODS: CT, MRI and clinical features in 16 patients with histologically proven RIEACCs were retrospectively reviewed. There were 2 females and 14 males, with a median age of 52.5 years at the time of diagnosis of RIEACC. Imaging parameters including lesion extent, size, margin, shape, bone destruction, adjacent structure invasion, density/signal intensity, and pattern and degree of enhancement were assessed...
June 2015: British Journal of Radiology
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