Stocker Magdalena, Hempel John-Martin
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Salzburg, Muellner Hauptstraße 48, 5020, Salzburg, Austria.
Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377, Munich, Germany.
Sci Rep. 2025 Jul 21;15(1):26367. doi: 10.1038/s41598-025-11742-z.
Malignant otitis externa (MOE) is a rare, potentially life-threatening disease. It involves inflammation of the external auditory canal with concomitant osteomyelitis of the temporal bone, usually with evidence of Pseudomonas aeruginosa. The patient population is often immunocompromised, mostly due to inadequately treated type 2 diabetes mellitus or the use of immunosuppressants. Erosion of the temporal bone is common and can lead to complications such as peripheral facial nerve paralysis, meningitis, and/or cochlear and vestibular damage. The treatment of choice is usually several weeks of antibiogram-controlled intravenous antimicrobial therapy and possibly surgical treatment. Furthermore, if available, optimization of antidiabetic therapy is essential. A retrospective, descriptive, single-center study was performed to characterize consecutive real-life patients with MOE at the University Hospital Munich, Ludwig-Maximilians University, Germany. Thirteen patients with MOE were included in this study. Patient data concerning age, sex, comorbidities, pathogen spectrum, radiological imaging, antibiotic and surgical treatment and other variables were analyzed. In this study, we present a detailed description of a cohort of patients with MOE and propose a therapeutic algorithm that focuses on a combination of antibiotic therapy and surgical debridement of the affected tissue.
恶性外耳道炎（MOE）是一种罕见的、可能危及生命的疾病。它涉及外耳道炎症并伴有颞骨骨髓炎，通常有铜绿假单胞菌感染的证据。患者群体往往存在免疫功能低下的情况，主要是由于2型糖尿病治疗不充分或使用免疫抑制剂所致。颞骨侵蚀很常见，可导致周围性面神经麻痹、脑膜炎和/或耳蜗及前庭损伤等并发症。通常的治疗选择是进行数周的根据药敏试验控制的静脉抗菌治疗，可能还需要手术治疗。此外，若条件允许，优化抗糖尿病治疗至关重要。在德国慕尼黑大学医院、路德维希 - 马克西米利安大学进行了一项回顾性、描述性、单中心研究，以对连续性现实生活中的MOE患者进行特征分析。本研究纳入了13例MOE患者。分析了患者的年龄、性别、合并症、病原体谱、放射影像学、抗生素及手术治疗等相关数据以及其他变量。在本研究中，我们详细描述了一组MOE患者，并提出了一种治疗方案，该方案侧重于抗生素治疗与对受影响组织进行手术清创相结合。
