Methods and materials:
A retrospective case series analysis was conducted, including all patients hospitalized due to NOE between the years 1990-2018. The research was conducted in compliance and approval of the requirements of the medical center’s institutional review board; the Human Subject Research Committee.
Inclusion criteria included: 1) patients 18 years and above 2) diagnosed NOE, based on the Cohen and Friedman classification93) absence of chronic middle ear disease 4) no history of ear surgery due to chronic ear disease 5) hospitalization duration of more than 7 days. Exclusion criteria included: 1) patients younger than 18 years, 2) history of chronic middle ear disease 3) patients who underwent surgery due to chronic ear disease 4) hospitalization duration of less than 7 days.
Data collected included: 1) patients age and gender 2) complaints at admission 3) physical findings at admission 4) laboratory findings 5) radiological imaging 6) culture results7) antibiotic treatment 8) type of surgery performed 9)duration of hospitalization.
Medical and laboratory data retrieved in order to evaluate DMincluded: 1) duration of DM 2) medical comorbidities associated with DM at time of admission 3) hemoglobin A1c levels (HbA1c) reflecting DM control at time of admission 4) Most recentmicro-albuminuria levels, defined as microalbuminuria collected up to six months prior to admission 5) Blood glucose measurements duringhospitalization. For statistical analysis, and based on the American diabetes association10, mean blood glucose measurements were divided into two groups using a cutoff of 140 mg/dL.
Two main measures were used in order to evaluate disease outcome: 1) duration of hospitalization – patients hospitalized more or less than 20 days 2) need for surgical intervention under general anesthesia.