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Malignant otitis externa

A M J L van Kroonenburgh, W L van der Meer, R J P Bothof, M van Tilburg, J van Tongeren, A A Postma
Purpose of Review: To give an up-to-date overview of the strengths and weaknesses of current imaging modalities in diagnosis and follow-up of skull base osteomyelitis (SBO). Recent Findings: CT and MRI are both used for anatomical imaging, and nuclear techniques aid in functional process imaging. Hybrid techniques PET-CT and PET-MRI are the newest modalities which combine imaging strengths. Summary: No single modality is able to address the scope of SBO...
2018: Current Radiology Reports
John Scott Earwood, Tyler Sherrod Rogers, Nicholas Alan Rathjen
Otalgia (ear pain) is a common presentation in the primary care setting with many diverse causes. Pain that originates from the ear is called primary otalgia, and the most common causes are otitis media and otitis externa. Examination of the ear usually reveals abnormal findings in patients with primary otalgia. Pain that originates outside the ear is called secondary otalgia, and the etiology can be difficult to establish because of the complex innervation of the ear. The most common causes of secondary otalgia include temporomandibular joint syndrome and dental infections...
January 1, 2018: American Family Physician
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
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
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
J P N Goh, A Karandikar, S C Loke, T Y Tan
PURPOSE: Skull base osteomyelitis (SBOM) is an inflammatory process which often arises from malignant otitis externa (MOE); the diffuse skull base and adjacent soft tissue involvement may be mistaken at initial imaging for advanced nasopharyngeal carcinoma (NPC), especially if there is no prior knowledge of MOE, direct spread from the sphenoid sinus or in atypical presentations of MOE. This study aims to evaluate imaging features on MR that may differentiate SBOM from NPC. MATERIALS AND METHODS: The MR examinations of 26 patients diagnosed with SBOM between January 1996 and January 2013 were retrospectively reviewed...
July 2017: American Journal of Otolaryngology
Philippe Frederick Bowles, Victoria Perkins, Eyal Schechter
An 89-year-old man presented to the outpatient clinic with a 2-month history of persistent unilateral left-sided otalgia, otorrhoea and reduced hearing despite oral and topical antibiotics. Treatment was protracted, requiring a 4-month hospital admission for intravenous antifungal medication as well as 3 further months of oral antifungal treatment. We describe the clinical presentation, complications and treatment of this potentially fatal condition in the context of an unusual, and easily missed, causative organism...
March 27, 2017: BMJ Case Reports
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
Diana Bhasker, Angela Hartley, Frank Agada
We performed a retrospective review of all patients with malignant otitis externa (MOE) treated in our center between July 2004 and December 2012 to evaluate the current epidemiology in our region and to ascertain causative factors associated with the perceived increase in the number of cases diagnosed. Eleven patients were identified (5 men and 6 women), with a mean age of 77 years (range: 38 to 97 years). Diabetes was present in 36%. Pseudomonas aeruginosa was the causative organism in 64% of cases; all pathogens were sensitive to ciprofloxacin...
February 2017: Ear, Nose, & Throat Journal
Michael J Sylvester, Saurin Sanghvi, Viral M Patel, Jean Anderson Eloy, Yu-Lan Mary Ying
OBJECTIVES/HYPOTHESIS: Malignant otitis externa (MOE) is a rare disorder that is not well studied in the inpatient setting. The Nationwide Inpatient Sample (NIS) database was utilized to analyze characteristics and predischarge outcomes of hospitalized MOE patients. METHODS: MOE hospitalizations were identified in the 2002 to 2013 NIS. Patient demographics, length of hospital stay, hospital charges, concomitant diagnoses, treatment-related procedures, complications, and in-hospital mortality rates were examined, with comparisons made among age cohorts and between diabetes mellitus (DM) and non-DM groups...
October 2017: Laryngoscope
Sharafine Stephen, Beula Subashini, Regi Thomas, Ajay Philip, Rajan Sundaresan
Malignant otitIs externa (skull base osteomyelitis) is predominantly caused by bacteria while fungal etiology is rare. We report a middle aged diabetic gentleman who succumbed to invasive skull base infection due to Apophysomyces elegans a fungus belonging to Zygomycetes which causes only skin and soft tissue infections. Mortality and invasive infections due to this genus is rarely reported, especially in the ear.
February 2016: Journal of the Association of Physicians of India
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
Haruka Miyabe, Atsuhiko Uno, Takahiro Nakajima, Natsue Morizane, Keisuke Enomoto, Masayuki Hirose, Toshinori Hazama, Yukinori Takenaka
Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction...
2016: Case Reports in Otolaryngology
Sujata N Muranjan, Satish V Khadilkar, Sanjay C Wagle, Sunila T Jaggi
The aim of this study is to describe the clinical presentation of central skull base osteomyelitis and to discuss the classical imaging findings and various diagnostic and therapeutic challenges faced in the management of this condition. This is a retrospective analysis of inpatient case records, carried out in a multidisciplinary tertiary care hospital. The study subjects included five elderly diabetic patients presenting to the ENT surgeon or neurologist with headache followed by multiple cranial nerve paralysis with no temporal bone involvement in four patients and a past history of otitis externa in one patient...
June 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
David J Thomson, Nick J Slevin, William M Mendenhall
There is an established role for post-operative radiotherapy in the treatment of benign and malignant salivary gland tumours. For benign disease, the addition of radiotherapy improves local tumour control in cases with incomplete excision, involved surgical margins or multi-focal disease recurrence. After capsule rupture or spillage alone, surveillance should usually be advised. For malignant disease, post-operative radiotherapy is recommended for an advanced tumour stage, high-grade tumour, perineural or lympho-vascular invasion, close or positive resection margins, extra-parotid extension or lymph node involvement...
2016: Advances in Oto-rhino-laryngology
Marion Montava, Sophie Giusiano, Marianne Jolibert, Jean-Pierre Lavieille
No abstract text is available yet for this article.
February 15, 2016: Brazilian Journal of Otorhinolaryngology
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
Seung Hee Baik, Yoon Kyung Choi, Hyun Seo Kim, Young Kyung Yoon, Jang Wook Sohn, Min Ja Kim
PURPOSE: A probable case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) due to linezolid use is reported. SUMMARY: An 81-year-old Korean woman hospitalized for progressive malignant otitis externa due to methicillin-resistant Staphylococcus aureus infection was started on linezolid therapy (600 mg i.v. twice daily). On day 22 of linezolid use, the patient had severe hyponatremia (serum sodium concentration, 118 meq/L), with stable vital signs and no specific physical findings except for somnolence...
November 1, 2015: American Journal of Health-system Pharmacy: AJHP
Hadeel M Aljafar, Sari S Alsuhibani, Mohammad S Alahmari, Musaed A Alzahrani
Otologic manifestations in chronic lymphocytic leukemia (CLL) are common presentations. However, temporal bone metastasis is rarely described as a sign of relapsing CLL. A 65-year-old male diabetic patient known to have CLL on remission presented to the outpatient otolaryngology clinic with a one month history of progressive bilateral otalgia and right otorrhea, despite multiple courses of antibiotics. He was admitted with suspicion of malignant otitis externa. Left ear showed large hemorrhagic bullae on the posterior segment of tympanic membrane...
October 2015: Saudi Medical Journal
Shawn M Stevens, Paul R Lambert, Andrew B Baker, Ted A Meyer
OBJECTIVES: 1) Stratify malignant otitis externa into severe and nonsevere disease categories. 2) Predict treatment courses and outcomes based on this stratification. SETTING: Tertiary center. PATIENTS: Retrospective review 2004 to 2014; 28 patients. Inclusion criteria are a diagnosis by senior authors, radiographic evidence of disease, admission for intravenous antibiotics/debridement, minimum 1 year of follow-up. INTERVENTIONS: Severe group stratification if two or more of the following: cranial nerve VII palsy, fungal positive culture, relapse, surgery performed, major radiographic findings...
September 2015: Otology & Neurotology
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