Treatment protocol:
Upon admission, all patients received empiric treatment comprising of
quinolone or third generation cephalosporin. Further treatment was based
on the pathogen’s sensitivity profile. In cases where no pathogen was
isolated, empiric intravenous anti-PA antibiotic was continued.
Anti-fungal treatment was initiated only in cases of positive cultures.
All patients underwent daily examination and local debridement.
Granulation tissue was removed and sent for pathological evaluation in
all patients. Indications for surgery were 1) no response to
conservative treatment, as assessed by a senior otologist 2) new onset
facial palsy or presence of facial nerve palsy not responding to
treatment.