Gaurav Chawdhary1, Miran Pankhania2, Susan Douglas2, Ian Bottrill3. 1. a Department of Otolaryngology , Milton Keynes University Hospital , Milton Keynes, UK. 2. b ENT Department , Rotherham District General Hospital , Rotherham , UK. 3. c Department of ENT , John Radcliffe Hospital , Oxford, UK.
Abstract
INTRODUCTION: Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making. This survey aims to report the experience of 221 otolaryngologists in this condition. MATERIALS AND METHODS: Internet survey administered to the membership of the British Association of Otorhinolaryngology - Head and Neck Surgery (ENT UK). RESULTS: Respondents' detailed replies on diagnosis, treatment and follow up are presented. One third of respondents reported increasing incidence of NOE. Over 80% diagnosed NOE based on pre-existing risk factors, severe pain, non-resolution of infection and CT scan. Most respondents managed NOE with intravenous antibiotics (90%) and blood sugar control (82%). There was less agreement in certain aspects of management including the role of surgery and the nature and duration of follow up. CONCLUSIONS: Our survey provides a picture of NOE management in the UK. While there is consensus in some aspects of NOE management, other aspects attract widely differing answers. This may reflect the lack of strong evidence in the literature. Future work should aim to address this.
INTRODUCTION:Necrotising otitis externa (NOE) is a rare infection causing skull base osteomyelitis. The evidence regarding NOE consists mostly of case series. Hence, there is a limited evidence base to guide decision-making. This survey aims to report the experience of 221 otolaryngologists in this condition. MATERIALS AND METHODS: Internet survey administered to the membership of the British Association of Otorhinolaryngology - Head and Neck Surgery (ENT UK). RESULTS: Respondents' detailed replies on diagnosis, treatment and follow up are presented. One third of respondents reported increasing incidence of NOE. Over 80% diagnosed NOE based on pre-existing risk factors, severe pain, non-resolution of infection and CT scan. Most respondents managed NOE with intravenous antibiotics (90%) and blood sugar control (82%). There was less agreement in certain aspects of management including the role of surgery and the nature and duration of follow up. CONCLUSIONS: Our survey provides a picture of NOE management in the UK. While there is consensus in some aspects of NOE management, other aspects attract widely differing answers. This may reflect the lack of strong evidence in the literature. Future work should aim to address this.
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
Authors: Wilhelmina L van der Meer; Jérôme J Waterval; Henricus P M Kunst; Cristina Mitea; Sjoert A H Pegge; Alida A Postma Journal: Eur Arch Otorhinolaryngol Date: 2021-04-25 Impact factor: 2.503