Hopkins M E, Bennett A, Henderson N, MacSween K F, Baring D, Sutherland R
Department of ENT, NHS Lothian, Edinburgh, Scotland, UK.
Department of Microbiology, NHS Lothian, Edinburgh, Scotland, UK.
J Laryngol Otol. 2020 Jun;134(6):487-492. doi: 10.1017/S0022215120001061. Epub 2020 Jun 5.
Necrotising otitis externa is a progressive infection of the external auditory canal which extends to affect the temporal bone and adjacent structures. Progression of the disease process can result in serious sequelae, including cranial nerve palsies and death. There is currently no formal published treatment guideline.
This study aimed to integrate current evidence and data from our own retrospective case series in order to develop a guideline to optimise necrotising otitis externa patient management.
A retrospective review of necrotising otitis externa cases within NHS Lothian, Scotland, between 2013 and 2018, was performed, along with a PubMed review.
Prevalent presenting signs, symptoms and patient demographic data were established. Furthermore, features of cases associated with adverse outcomes were defined. A key feature of the guideline is defining at-risk patients with initial intensive treatment. Investigations and outcomes are assessed and treatment adjusted appropriately.
This multi-departmental approach has facilitated the development of a succinct, systematic guideline for the management of necrotising otitis externa. Initial patient outcomes appear promising.
坏死性外耳道炎是外耳道的一种进行性感染，可蔓延至颞骨及邻近结构。疾病进程的进展可导致严重的后遗症，包括颅神经麻痹和死亡。目前尚无正式发表的治疗指南。
本研究旨在整合现有证据和我们自己回顾性病例系列的数据，以制定优化坏死性外耳道炎患者管理的指南。
对2013年至2018年期间苏格兰NHS Lothian地区的坏死性外耳道炎病例进行回顾性研究，并对PubMed进行检索。
确定了常见的症状、体征和患者人口统计学数据。此外，还定义了与不良结局相关的病例特征。该指南的一个关键特征是确定需要初始强化治疗的高危患者。对检查和结局进行评估，并适当调整治疗。
这种多部门方法有助于制定一份简洁、系统的坏死性外耳道炎管理指南。患者的初始结局似乎很有希望。
