Malignant otitis externa in upper Egypt: why do not all diabetics have malignant otitis externa?

ABSTRACT

Eighteen diabetic patients [7 men and 11 women, with an age ranged between 50 and 75 years] among 1730 cases of malignant otitis externa in the ENT Clinic at Assiut University Hospitals were studied and treated in this work. This group consisted of seven men and eleven women. Diabetes was long-standing in all patients and uncontrolled, except in one. Laboratory investigations in the form of high and low-density lipids, ESR, creatinine and blood sugar curves were done to all patients. Biopsy for histopathological examination was taken from the granulation tissues or aural polyp. Computerized tomography of the temporal bones and radioisotope bone scan using technetium 99 MDP was done to all patients in the Nuclear Medicine Unit in Assiut University Hospitals. The clinical features and presentation were summarized. The strategy of the diagnosis and treatment was discussed. The combination of antibiotic and drugs that improve microcirculation was found to be essential in treatment of malignant otitis externa. Liporegulation drugs are also valuable in controlling high levels of LDL. ESR is a useful tool to monitor patients with MOE during treatment and in the follow up