Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
University of Central Florida College of Medicine, Orlando, Florida.
Otol Neurotol. 2020 Sep;41(8):1004-1011. doi: 10.1097/MAO.0000000000002723.
To assess for changes in trends of the disease process, management, and outcomes of necrotizing otitis externa (NOE) over the last decade.
Articles in English, published between January 2011 and June 2019, were searched in PubMed, Scopus, Web of Science, ScienceDirect, and the Cochrane Database.
Inclusion criteria: 1) reported evidence of NOE, 2) details on patient demographic and underlying medical disorder, 3) details on treatments, 4) documented outcomes, and 5) greater than 10 cases.
Study demographics, underlying conditions, infectious etiology, treatments, signs and symptoms, and outcomes.
Ten studies, totalling 284 patients with a mean age of 67.8 years, were included. The time period of collected patient data ranged from 2000 to 2018. Temporal subgroup analysis was conducted before and after 2009. Cure rate was lower in the post-2009 group (76.0 versus 94.1%, p < 0.01) while disease-specific mortality remained stable. Increases in proportions of diabetes and culture negative results (p < 0.01) were also observed in this latter group. Rate of extensive surgery and the use of ciprofloxacin decreased (p < 0.01), while the use of ceftazidime increased in the post-2009 group (p < 0.01).
A decrease in cure rate of NOE patients was observed in the setting of an increase in prevalence of diabetes. Various antipseudomonal agents are being used and an increase in culture negative results is seen.
评估过去十年中坏死性外耳道炎（NOE）疾病过程、治疗方法和结局趋势的变化。
在 PubMed、Scopus、Web of Science、ScienceDirect 和 Cochrane 数据库中检索 2011 年 1 月至 2019 年 6 月间发表的英文文章。
纳入标准：1）报告有 NOE 证据，2）有患者人口统计学和潜在医学疾病的详细信息，3）有治疗方法的详细信息，4）有记录的结果，5）大于 10 例。
研究人口统计学、潜在状况、感染病因、治疗方法、症状和结果。
共纳入 10 项研究，总计 284 例患者，平均年龄为 67.8 岁。收集患者数据的时间段从 2000 年到 2018 年不等。进行了 2009 年前和后的时间亚组分析。2009 年后组的治愈率较低（76.0%比 94.1%，p<0.01），而疾病特异性死亡率保持稳定。在后一组中，还观察到糖尿病和培养阴性结果的比例增加（p<0.01）。广泛手术和使用环丙沙星的比例降低（p<0.01），而 2009 年后组使用头孢他啶的比例增加（p<0.01）。
在糖尿病患病率增加的情况下，NOE 患者的治愈率下降。各种抗假单胞菌药物正在被使用，培养阴性结果的比例增加。
