Azeez Taoreed Adegoke, Adeagbo Adekunle Kazeem
Department of Medicine, Reddington Multi-Specialist Hospital, 12, Idowu Martins Street, Victoria Island, Lagos, Nigeria.
Department of ENT, Reddington Multi-Specialist Hospital, Lagos, Nigeria.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3277-3287. doi: 10.1007/s12070-023-03939-3. Epub 2023 Jun 20.
Diabetes mellitus is one of the risk factors for malignant otitis externa. There are very few studies on the disease in Africa and there is a need to pool the prior studies to highlight the characteristics of the disease. The study type is a systematic review and the PRISMA guidelines were followed. Using the appropriate terms, relevant medical databases were systematically searched. Thirty-two studies met the eligibility criteria with a total sample size of 848, who were mainly elderly. Diabetes mellitus was present in 94% of the participants. Average duration of diabetes diagnosis in the participants was 12.4 years. The pooled HbA1c was 9.8%. The most common symptoms were otalgia (96.1%), otorrhoea (75.8%) and hearing loss (56.1%). was the most common isolate (72%). Fluoroquinolones and the 3rd-generation cephalosporins were the preferred antibiotics. The pooled cure rate from antimicrobial usage was 76.2%. In addition to medications, 24.6% of the affected individuals required debridement. About 1.6% of the participants died from malignant otitis externa. Malignant otitis externa is associated with poorly controlled diabetes. Pseudomonas is the most common cause and a significant proportion gets cured with prolonged antibiotherapy.
糖尿病是恶性外耳道炎的危险因素之一。非洲对该疾病的研究非常少，有必要汇总先前的研究以突出该疾病的特征。研究类型为系统评价，并遵循PRISMA指南。使用适当的术语，系统地检索了相关医学数据库。32项研究符合纳入标准，总样本量为848例，主要为老年人。94%的参与者患有糖尿病。参与者糖尿病诊断的平均时长为12.4年。合并的糖化血红蛋白（HbA1c）为9.8%。最常见的症状是耳痛（96.1%）、耳漏（75.8%）和听力损失（56.1%）。 是最常见的分离株（72%）。氟喹诺酮类和第三代头孢菌素是首选抗生素。抗菌药物使用后的合并治愈率为76.2%。除药物治疗外，24.6%的受影响个体需要清创。约1.6%的参与者死于恶性外耳道炎。恶性外耳道炎与糖尿病控制不佳有关。铜绿假单胞菌是最常见的病因，相当一部分患者通过延长抗生素治疗得以治愈。
