Department of Otolaryngology and Head and Neck Surgery, University of Nuevo Leon, Mexico.
Department of Otolaryngology and Head and Neck Surgery, University of Nuevo Leon, Mexico.
Am J Otolaryngol. 2021 Mar-Apr;42(2):102894. doi: 10.1016/j.amjoto.2020.102894. Epub 2021 Jan 5.
Malignant otitis externa is a progressive infection of the external auditory canal and skull base. Pseudomonas aeruginosa is the most isolated microorganism and it affects mostly to diabetic, elderly, and immunocompromised individuals. Non-resolving otalgia and chronic otorrhea are the clinical manifestations presented. Facial nerve palsy is a common and well recognized complication. (Computed tomography) CT scan is useful for initial assessment, Technetium-99m is highly sensitive and is part of the protocol for diagnosis. Treatment should be individualized, with multidisciplinary cooperation among specialties. Management involves systemic antipseudomonal antibiotics and monitoring with radiologic techniques, it also involves the strict control of diabetes. It is essential to follow up the patients for at least a year post-treatment. In refractory malignant otitis externa and affection of facial nerve, surgical management is recommended. We reviewed the most recent studies on epidemiology, clinical manifestations, diagnosis, and treatment to provide an update on Malignant Otitis Externa that can offer an overview for clinical practice and future research.
恶性外耳炎是外耳道和颅底的进行性感染。铜绿假单胞菌是最常分离的微生物,它主要影响糖尿病、老年和免疫功能低下的个体。未解决的耳痛和慢性耳漏是其临床表现。面神经瘫痪是一种常见且公认的并发症。(计算机断层扫描)CT 扫描有助于初步评估,锝-99m 高度敏感,是诊断方案的一部分。治疗应个体化,多学科间的专业合作。管理包括全身抗假单胞菌抗生素和影像学技术监测,还包括严格控制糖尿病。治疗后至少随访患者一年是至关重要的。对于难治性恶性外耳炎和面神经受累,推荐手术治疗。我们回顾了最近关于流行病学、临床表现、诊断和治疗的研究,提供了恶性外耳炎的最新信息,为临床实践和未来研究提供了概述。