Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Braz J Otorhinolaryngol. 2023 Jan-Feb;89(1):66-72. doi: 10.1016/j.bjorl.2021.08.011. Epub 2021 Oct 26.
To determine the diagnostic accuracy of Necrotizing Otitis Externa (NOE) based on radiologic studies.
The PubMed, Cochrane, Embase, Web of Science, SCOPUS, and Google Scholar databases were searched. True-positive and false-negative results were extracted for each study. Methodological quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.
The included studies contained data on 37 studies diagnosed with NOE. The sensitivity of gallium-67, technetium-99m, and Magnetic Resonance Imaging (MRI) was 0.9378 (0.7688-0.9856), 0.9699 (0.8839-0.9927), and 0.9417 (0.6968-0.9913), respectively. For Computed Tomography (CT), the positive criteria consisted of bony erosion alone and bony erosion plus any soft tissue abnormality. The sensitivity of CT based only on bony erosion was 0.7062 (0.5954-0.7971); it was higher 0.9572 (0.9000-0.9823) when based on bony erosion plus any soft tissue abnormality.
The diagnostic sensitivity of technetium-99m, gallium-67, and MRI was favorable. On CT, the presence of bony erosion may be a useful diagnostic marker of NOE, but the diagnostic sensitivity will be even higher if the criterion of any soft tissue abnormality is also included; however, care should be taken when interpreting the results. Our study demonstrates the potential utility of radiology studies for diagnosing NOE, but their lack of specificity must be considered, and standardized anatomic criteria are still needed.
2A.
基于影像学研究，确定坏疽性外耳道炎（NOE）的诊断准确性。
检索 PubMed、Cochrane、Embase、Web of Science、SCOPUS 和 Google Scholar 数据库。为每项研究提取真阳性和假阴性结果。使用诊断准确性研究质量评估工具 2（QUADAS-2）评估方法学质量。
纳入的研究包含 37 项诊断为 NOE 的研究数据。镓-67、锝-99m 和磁共振成像（MRI）的灵敏度分别为 0.9378（0.7688-0.9856）、0.9699（0.8839-0.9927）和 0.9417（0.6968-0.9913）。对于计算机断层扫描（CT），阳性标准为单纯骨侵蚀和骨侵蚀加任何软组织异常。仅基于骨侵蚀的 CT 灵敏度为 0.7062（0.5954-0.7971）；当基于骨侵蚀加任何软组织异常时，灵敏度更高，为 0.9572（0.9000-0.9823）。
锝-99m、镓-67 和 MRI 的诊断灵敏度较好。在 CT 上，骨侵蚀的存在可能是诊断 NOE 的有用标记物，但如果包括任何软组织异常的标准，诊断灵敏度会更高；然而，在解释结果时应谨慎。本研究表明影像学研究对诊断 NOE 具有潜在的应用价值，但必须考虑其特异性不足，并且仍需要标准化的解剖学标准。
2A。
