OBJECTIVE: To carry out a systematic review of scientific evidence available about necrotizing otitis externa, emphasizing epidemiologic data, diagnosis criteria, treatment protocols, follow-up criteria, prognosis factors, and chronologic evolution. DATA SOURCES: PubMed/MEDLINE and the Cochrane Database of Systematic Reviews were searched for publications in English and French languages, between 1968 and October 1, 2011. STUDY SELECTION: We included publications of all types including at least 6 cases. We excluded publications focused on cranial base osteomyelitis not originating from the external ear and publications limited to a specific population. DATA EXTRACTION: We assessed publication quality according to international guidelines. DATA SYNTHESIS: For each publication, data were entered in a spreadsheet software for analysis. We excluded individual data already published in other studies or reviews. CONCLUSION: Our review revealed the absence of strong scientific evidence regarding diagnosis criteria, treatment protocols and follow-up criteria. This implies the use of highly empirical indexes of suspicion in clinical practice. Our review confirmed the existence of a typical but not exclusive population at risk (aged, male, and diabetic patient) and also revealed major issues: lack of primary prevention in population at risk, delays before referral and management, bacteriologic issues caused by antibiotic misuse (agent identification problems, rise of resistant strains), persistence of recurrent cases. A better diffusion of medical information should help improve the management of this severe disease.
OBJECTIVE: To carry out a systematic review of scientific evidence available about necrotizing otitis externa, emphasizing epidemiologic data, diagnosis criteria, treatment protocols, follow-up criteria, prognosis factors, and chronologic evolution. DATA SOURCES: PubMed/MEDLINE and the Cochrane Database of Systematic Reviews were searched for publications in English and French languages, between 1968 and October 1, 2011. STUDY SELECTION: We included publications of all types including at least 6 cases. We excluded publications focused on cranial base osteomyelitis not originating from the external ear and publications limited to a specific population. DATA EXTRACTION: We assessed publication quality according to international guidelines. DATA SYNTHESIS: For each publication, data were entered in a spreadsheet software for analysis. We excluded individual data already published in other studies or reviews. CONCLUSION: Our review revealed the absence of strong scientific evidence regarding diagnosis criteria, treatment protocols and follow-up criteria. This implies the use of highly empirical indexes of suspicion in clinical practice. Our review confirmed the existence of a typical but not exclusive population at risk (aged, male, and diabeticpatient) and also revealed major issues: lack of primary prevention in population at risk, delays before referral and management, bacteriologic issues caused by antibiotic misuse (agent identification problems, rise of resistant strains), persistence of recurrent cases. A better diffusion of medical information should help improve the management of this severe disease.
Authors: Susanne Wiegand; Reinhard Berner; Antonius Schneider; Ellen Lundershausen; Andreas Dietz Journal: Dtsch Arztebl Int Date: 2019-03-29 Impact factor: 5.594
Authors: S H Hodgson; V J Sinclair; J Arwyn-Jones; K Oh; K Nucken; M Perenyei; V Sivapathasingam; P Martinez-Devesa; S T Pendlebury; J D Ramsden; P C Matthews; P Pretorius; M I Andersson Journal: J Laryngol Otol Date: 2022-01-19 Impact factor: 2.187