Negative prognostic factors for malignant external otitis and the effectivness of the treatment

Malignant external otitis is a very rare and serious infection of temporal bone and surrounding tissues. This report aimed to determine negative prognostic factors, effectiveness of treatment and companing with literature. Fourtyone patient?s files who were hospitalized in Cukurova University Medical Faculty Ear Nose and Throat department were examined retrospectively. Patients were between 38 and 90 years old and median age was 63,24. Fourty of them were diabetic. Nine of 19 insulin users (47,4%) and 5 of oral antidiabetic users (23,8%) were found to be in negative prognostic group. There were 7 patients with facial paralysis and 3 of them died. There were bilateral diseases in 5 patients and 4 of them had recurrence after treatment. Eight patients had advenced radiological findings and 1 of them died (12,5%). And 6 of 8 patients who had serious infection of temporal bone assesed in negative prognostic group.In our study 73,2% patients had combination antibiotic therapy. The most frequently used antibacterial agents were floroquinolon and antipseudomonal penicilin in combination (17 patients (41,5%)). The duration of intravenous treatment was between 20 and 106 days and the median time was 41,5 days. We had a rate of 22% recurrence and these patients were rehospitalized. Five patients had surgery and 1 patient had hyperbaric oxygen treatment. And 4 patients were lost because of comorbid illnesses.In our stady we had 27 patients (66%) cured, 6 patients (14,6%) cured after second hospitalization, 4 patients (9,7%) cured with permanent peripherical facial paralysis and 4 patients (9,7%) were lost during treatment. İnsulin dependent diabetes, bilateral disease, advenced infection and facial paralysis were considered to be negative prognostic factors. The success of treatment was considered to be dependent on control of diabetes, daily ear aspirations, and long term combined antibiotherapy. Early diagnosis and treatment is essential.