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Artikel ; Online: The association between radiological spreading pattern and clinical outcomes in necrotizing external otitis.

van der Meer, W Leentje / Bayoumy, Ahmed B / Otten, Josje J / Waterval, Jerome J / Kunst, Henricus P M / Postma, Alida A

Journal of otology

2022  Band 17, Heft 3, Seite(n) 156–163

Abstract: Objectives: Necrotizing external otitis (NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.: Methods: ... ...

Abstract Objectives: Necrotizing external otitis (NEO) is a rare infectious disease of the skull base. The purpose of this study was to determine whether clinical outcomes of NEO can be correlated to different infectious spread patterns.
Methods: Retrospective chart review from 2010 to 2019 with NEO patients, who were divided into two cohorts: single spreading patterns (group A) or complex spreading patterns (group B) as diagnosed by CT. Clinical symptoms, diagnostic and treatment delay, course of disease, complications, and duration of antibiotic exposure were retrospectively collected from patient records.
Results: 41 NEO patients were included, of which 27 patients belonged to group A (66%). The disease-related mortality rate was 12.2% among the entire cohort, no differences were found between group A and B. Higher rates of N.VII (42.9% vs 14.8% P = 0.047) and N. IX palsies were found in group B compared to group A (28.6% vs 3.7%, P = 0.039). The median duration of antibiotic use was significantly different for a complex spreading pattern, clinical recovery and hospitalizations. Complications were associated with higher diagnostic delay and with a complex spread pattern. The median duration of follow-up was 12.0 (IQR 6.0-19.5) months.
Conclusion: NEO is a severe disease, with significant mortality and morbidity (cranial nerve palsies). The radiological spread pattern may assist in predicting clinical outcome. Furthermore, complex spread patterns are associated with higher rates of clinical nerve palsies (N. VII and N.IX), complications, surgery rates and longer duration of antibiotic use. Diagnostic delay was associated with mortality, complications and facial palsies.
Level of evidence: Level IV.
Sprache Englisch
Erscheinungsdatum 2022-06-03
Erscheinungsland China
Dokumenttyp Journal Article
ZDB-ID 2621477-5
ISSN 2524-1753 ; 1672-2930
ISSN (online) 2524-1753
ISSN 1672-2930
DOI 10.1016/j.joto.2022.05.002
Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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