Malignant otitis externa: An Australian case series

ObjectivesTo establish a clinicopathological profile of malignant otitis externa (MOE) in an Australian tertiary referral institution.Study DesignRetrospective cohort outcomes study.Methods24 patients were identified with MOE between January 1998 and July 2007. Patients were classified into Radiological Grades I–IV. Laboratory investigations Including C–reactive protein (CRP), white cell count (WCC), glycosylated haemoglobin (HBA1c) and average glucose level over admission were recorded.ResultsRadiological Grade was significantly associated with duration of therapy (rank correlation 0.57, p = 0.004). CRP was a useful indicator confirming disease resolution. Diabetics with MOE had elevated average blood sugar levels during their Hospital admission (p < 0.001) and had poor overall glycaemic control represented by Elevated HBA1c scores (p < 0.001).ConclusionsMalignant otitis externa is a rare disease, which is best managed in a multidisciplinary team setting. This practical grading system can be used to predict the duration of therapy at time of diagnosis, which enables the efficient utilisation of Hospital resources. Poorly controlled diabetics are more susceptible to developing.MOE than diabetics with satisfactory glycaemic control and may represent a subgroup of more brittle diabetics. CRP combined with appropriate clinical and radiological investigations is useful in assessing disease resolution.