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Necrotising otitis externa

Christopher Thompson, Rohit Gohil, Alex Bennett
An 80-year-old Caucasian man presented with an incidental and asymptomatic lesion in his right ear thought to be secondary to his use of hearing aids for presbycusis. He used Lyric hearing aids, designed for 24 hours-a-day use for 4 months at a time and had no other previous otological problems. He underwent a bony meatoplasty and vascular flap reconstruction via a retroauricular approach to remove the lesion for histological analysis and regrafting of the area. The lesion was confirmed on histopathology as an ear canal cholesteatoma...
November 29, 2017: BMJ Case Reports
S Unadkat, T Kanzara, G Watters
BACKGROUND: Necrotising otitis externa can be a devastating form of otitis externa. It typically tends to affect patients who are immunocompromised or diabetic. To date, there is very little in the literature about necrotising otitis externa in the immunocompetent patient population. CASE REPORTS: The present paper discusses both the clinical and radiological findings in three cases of necrotising otitis externa in an immunocompetent patient cohort. The common factor among all three patients was their advanced age...
January 2018: Journal of Laryngology and Otology
Yutaka Momota, Junya Yasuda, Nobuaki Arai, Masami Yamamoto, Hisashi Yoshimura, Mitsutaka Ikezawa, Shuji Suzuki, Kimimasa Takahashi, Toshinori Sako
CASE SUMMARY: A 14-year-old female spayed cat was referred for recurrent otitis externa and unusual proliferative lesions in both ear canals. The affected pinnae and external ear canals were covered with large reddish-to-dark-brown verrucous and necrotic tissue. Friable material and exudates occluded both ear canals. Proliferative lesions developed in both ears 2-3 weeks before referral. The histopathological diagnosis from two biopsies obtained from the friable materials with endoscopic biopsy forceps was proliferative and necrotising otitis externa (PNOE)...
January 2017: JFMS Open Reports
Isabel de Miguel-Martinez, Pilar Michelle Hernandez-Cabrera, María Aser Armesto-Fernández, Antonio Manuel Martín-Sánchez
No abstract text is available yet for this article.
January 2018: Enfermedades Infecciosas y Microbiología Clínica
Gaurav Chawdhary, Miran Pankhania, Susan Douglas, Ian Bottrill
INTRODUCTION: Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making. This survey aims to report the experience of 221 otolaryngologists in this condition. MATERIALS AND METHODS: Internet survey administered to the membership of the British Association of Otorhinolaryngology - Head and Neck Surgery (ENT UK). RESULTS: Respondents' detailed replies on diagnosis, treatment and follow up are presented...
August 2017: Acta Oto-laryngologica
G Chawdhary, S Hussain, R Corbridge
Central skull-base osteomyelitis (CSBO) is a rare life-threatening infection, usually resulting from medial spread of necrotising otitis externa. Here, we describe a case with no identifiable source of infection, causing a delay in diagnosis. An 80-year-old man with Crohn's disease treated with mesalazine presented with collapse and tonic-clonic seizure. Computed tomography and magnetic resonance imaging showed a nasopharyngeal mass that was initially thought to be a neoplasm. Awaiting formal biopsy, he represented with collapse and repeat imaging showed features of abscess formation...
January 2017: Annals of the Royal College of Surgeons of England
Yutaka Momota, Junya Yasuda, Mitsutaka Ikezawa, Jun Sasaki, Masaaki Katayama, Kenji Tani, Masahiro Miyabe, Eri Onozawa, Daigo Azakami, Katsumi Ishioka, Toshinori Sako
Proliferative and necrotising otitis externa (PNOE) is a very rare disease affecting the ear canals and concave pinnae of kittens. This report describes a 5-month-old cat with PNOE. Histopathological examination confirmed the diagnosis. Treatment was initiated with local injection of methylprednisolone acetate into the lesions. The cat was subsequently treated with clobetasol propionate cream, a potent topical glucocorticoid ointment. The cat showed marked improvement. While topical treatment with tacrolimus, an immunosuppressive agent, is reported to be an effective therapy, to the best of our knowledge, this is the first report to treat PNOE with local corticosteroid therapy...
January 10, 2017: Journal of Veterinary Medical Science
E Yeheskeli, R Abu Eta, H Gavriel, S Kleid, E Eviatar
OBJECTIVE: Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy. METHODS: A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy...
May 2016: Journal of Laryngology and Otology
Rushad Patell, Rupal Dosi, Rikin Raj, Shreyans Doshi
No abstract text is available yet for this article.
April 2016: Tropical Doctor
M Pankhania, A Bashyam, O Judd, P Jassar
No abstract text is available yet for this article.
June 2016: Clinical Otolaryngology
Daniel Hajioff, Samuel MacKeith
INTRODUCTION: Otitis externa is thought to affect 10% of people at some stage, and can present in acute, chronic, or necrotising forms. Otitis externa may be associated with eczema of the ear canal, and is more common in swimmers, in humid environments, in people with narrow ear canals, in hearing-aid users, and after mechanical trauma. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of empirical treatments for otitis externa? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review)...
June 15, 2015: Clinical Evidence
G Chawdhary, N Liow, J Democratis, O Whiteside
BACKGROUND: Necrotising (malignant) otitis externa is a severe infection causing temporal bone osteomyelitis. Although rare, our experience (reported herein) shows local doubling of cases in 2013. Hospital Episodes Statistics data for England over 14 years also indicate increased incidence nationally. Specific learning points in management are also discussed. METHODS: A retrospective review was conducted of patients admitted in 2013 to Wexham Park Hospital, Slough, UK (catchment population, 450 000)...
June 2015: Journal of Laryngology and Otology
S P Williams, T L Curnow, R Almeyda
Necrotising otitis externa is an uncommon and aggressive infection of the external auditory canal with a tendency to present in the elderly and immunocompromised patient. We report a series of twenty-five patients admitted to our institution over a four-year period with this diagnosis. We review the diagnosis and antimicrobial management of these cases, and propose a treatment algorithm based on our experience.
2014: B-ENT
Neil Foden, Christopher Burgess, Stephen Damato, James Ramsden
We present a case of an 81-year-old man who was diagnosed with a necrotising (malignant) otitis externa (NOE). Initial biopsies from the external auditory canal showed scanty squamous epithelium but no evidence of malignancy. Despite an initial improvement on intravenous antibiotics and subsequent discharge from hospital, the patient returned with worsening otalgia. Following readmission to the hospital, intravenous antibiotics were restarted. Despite this, the patient developed a lower motor neurone palsy of cranial nerve VII on the ipsilateral side of the pain...
2013: BMJ Case Reports
D V Lambor, C P Das, H C Goel, M Tiwari, S D Lambor, M V Fegade
BACKGROUND: Necrotising otitis externa, which is typically seen in elderly diabetics, is a severe infective disorder caused by Pseudomonas aeruginosa. There is lack of standard management policy for necrotising otitis externa, hence this study attempted to frame a protocol for management based on clinical parameters. METHOD: A retrospective study of 27 patients with necrotising otitis externa was conducted over 6 years in a tertiary care hospital. Data were analysed with regards to demographic characteristics, clinical features, investigations, staging and treatment modalities...
November 2013: Journal of Laryngology and Otology
John S Phillips, Stephen E M Jones
BACKGROUND: Malignant, or necrotising, otitis externa is a potentially fatal infection of the external ear canal and surrounding soft tissue and bone. It may be complicated by involvement of cranial nerves, principally the facial nerves and the contents of the jugular foramen. It is an uncommon condition mainly found in the elderly or in diabetics. OBJECTIVES: To assess the effectiveness of adjunctive hyperbaric oxygen treatment for malignant otitis externa. SEARCH METHODS: We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; ICTRP and additional sources for published and unpublished trials...
May 31, 2013: Cochrane Database of Systematic Reviews
Stefano Borio, Federico Massari, Francesca Abramo, Silvia Colombo
Proliferative and necrotising otitis externa is a rare and recently described disease affecting the ear canals and concave pinnae of kittens. This article describes a case of proliferative and necrotising otits externa in a young adult cat. In this case, the lesions did not affected the pinnae, but both ear canals were severely involved. Video-otoscopy revealed a digitally proliferative lesion, growing at 360° all around the ear canals for their entire length, without involvement of the middle ear. Histopathological examination confirmed the diagnosis, and the cat responded completely to a once-daily application of 0...
April 2013: Journal of Feline Medicine and Surgery
C Pulcini, P Mahdyoun, E Cua, I Gahide, L Castillo, N Guevara
Necrotising external otitis (NEO) is a rare but severe bone infection, usually due to Pseudomonas aeruginosa, the management of which is not standardised. Systemic antibiotic therapy is usually prescribed for at least 6 weeks, but no review has been published on this topic. We report our experience and have reviewed the literature regarding antibiotic therapy in NEO. Here we describe a case-series of consecutive NEO cases seen over an 8-year period (2004-2011) in a French tertiary-care teaching hospital. Since 2009 we have shortened the duration of antibiotic therapy to 6 weeks...
December 2012: European Journal of Clinical Microbiology & Infectious Diseases
Nicola Su, Irfan Syed, Richard Garth
Malignant or necrotising otitis externa is a rare but potentially fatal disease. The classic presentation is one of severe, unremitting, throbbing otalgia, which may progress to osteomyelitis, especially in the elderly diabetic or immunocompromised patient. The case described is of a 72-year-old immunocompetent, non-diabetic man who presented with facial weakness, dysphagia and weight loss. The admitting diagnosis or impression was that of a cerebrovascular event. The eventual diagnosis was that of skull based osteomyelitis secondary to malignant otitis externa complicating mastoid surgery...
2011: BMJ Case Reports
Vit Hubka, Alena Kubatova, Nada Mallatova, Petr Sedlacek, Jan Melichar, Magdalena Skorepova, Karel Mencl, Pavlina Lyskova, Blanka Sramkova, Milada Chudickova, Petr Hamal, Miroslav Kolarik
A collection of 178 Aspergillus isolates, recovered from Czech patients, mostly from 2007-2011, was subjected to multilocus DNA sequence typing using the ITS region, β-tubulin, and calmodulin genes. An unusually wide spectrum of etiologic agents that included 36 species of Aspergillus is discussed in the context of recent taxonomic and clinical reports. Invasive aspergillosis (IA), onychomycosis, and otitis externa were the predominant clinical entities. Five cases due to species newly proven as etiologic agents of human mycoses, as well as cases with unique clinical manifestations caused by unusual agents are discussed in more detail...
August 2012: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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