A retrospective review and multi-specialty, evidence-based guideline for the management of necrotising otitis externa

M E Hopkins, A Bennett, N Henderson, K F MacSween, D Baring, R Sutherland

Research output: Contribution to journalReview articlepeer-review

Abstract / Description of output

BACKGROUND: Necrotising otitis externa is a progressive infection of the external auditory canal which extends to affect the temporal bone and adjacent structures. Progression of the disease process can result in serious sequelae, including cranial nerve palsies and death. There is currently no formal published treatment guideline.

OBJECTIVE: This study aimed to integrate current evidence and data from our own retrospective case series in order to develop a guideline to optimise necrotising otitis externa patient management.

METHODS: A retrospective review of necrotising otitis externa cases within NHS Lothian, Scotland, between 2013 and 2018, was performed, along with a PubMed review.

RESULTS: Prevalent presenting signs, symptoms and patient demographic data were established. Furthermore, features of cases associated with adverse outcomes were defined. A key feature of the guideline is defining at-risk patients with initial intensive treatment. Investigations and outcomes are assessed and treatment adjusted appropriately.

CONCLUSION: This multi-departmental approach has facilitated the development of a succinct, systematic guideline for the management of necrotising otitis externa. Initial patient outcomes appear promising.

Original languageEnglish
Pages (from-to)487-492
Number of pages6
JournalThe Journal of Laryngology & Otology (JLO)
Issue number6
Early online date5 Jun 2020
Publication statusE-pub ahead of print - 5 Jun 2020

Keywords / Materials (for Non-textual outputs)

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents/therapeutic use
  • Ciprofloxacin/therapeutic use
  • Cranial Nerve Diseases/epidemiology
  • Disease Progression
  • Ear Canal/microbiology
  • Humans
  • Necrosis/diagnostic imaging
  • Otitis Externa/complications
  • Outcome Assessment, Health Care
  • Patient Care Management/methods
  • Practice Guidelines as Topic
  • Prevalence
  • Pseudomonas Infections/epidemiology
  • Pseudomonas aeruginosa/isolation & purification
  • Retrospective Studies
  • Scotland/epidemiology
  • Staphylococcal Infections/epidemiology
  • Staphylococcus aureus/isolation & purification
  • Temporal Bone/microbiology


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