Evaluation of the clinical and radiological features of patients with Malignant otitis externa (MOE).

INTRODUCTION

Malignant otitis externa (MOE) is a life-threatening infection of the external auditory canal and temporal bone.

OBJECTIVE

This study is designed to identify the clinical features, predisposing factors, radiological findings, complications, diagnoses, and management of MOE patients.

STUDY DESIGN

Retrospective cross-sectional study.

SETTING

Loghman-e-Hakim Hospital, Tehran, Iran.

METHODS

The study included 40 patients diagnosed with MOE from 2011 to 2023. The data extracted from medical records included demographic data, clinical signs and symptoms, radiological findings, laboratory data, predisposing factors, complications, treatments, and outcomes. Out of 37 patients, 21 were followed up.

RESULTS

The study found that the mean age of patients was 62.24 ± 11.44 years, with 62.2% being male. Otalgia and otorrhea were the most commonly reported symptoms, and mastoiditis was the most common radiological finding. Bone erosions and osteomyelitis were other important complications. Vascular complications were also observed in 7 patients. The study also found that most patients had underlying conditions such as diabetes mellitus, hypertension, ischemic heart disease, and renal disease. One patient passed away during hospitalization, while others improved and were discharged. Then, at follow-up, 11 patients died, mainly due to the progression of underlying disorders including cardiac, and renal manifestations.

CONCLUSION

Based on our findings, although MOE most commonly occurs in poorly-controlled diabetic or immunocompromised patients, it can also occur in individuals without known conditions. Furthermore, increasing the age and severity of DM could lead to more complications. In terms of medical therapy, coverage of gram-positive bacteria and an antipseudomonal regimen would be an effective treatment.