Introduction:
Necrotizing otitis externa (NOE) is a severe inflammatory process affecting the external ear and skull base. This condition is commonly seen among elderly patients with diabetesmellitus(DM), with a reported prevalence of 90-100%1,2. The most common pathogen associated with NOE is Pseudomonas Aeruginosa (PA), however the incidence of fungal and sterile culture NOE is rising3,4. Classically, surgery was the most common treatment for NOE and mortality rateswere as high as 50%5. Nowadays, with the introduction of anti-PA antibiotics, long term antibiotic treatment is the main stay, with surgery preserved for selected cases.
Although the association between NOE and DMis well established, there is littleknowledge in regards to the effects of DM duration and glycemic control with disease progression and outcome.Joshua et al6 reported that a history of diabetic related complications was associated with longer treatment duration andshorter survival in NOE patients. In contrast,Lohet al7reported that HbA1c levels, which reflect recent glycemic control, were not associated with disease outcome. Similarly, Franco-Vidal et al8reported that DM is not a prognostic factor in NOE.
In light of these controversies and limited data the aims of our study were:1. Examine the effect DM duration, as well aspreadmission glycemic control with NOE outcome. 2. Examine the effect of glycemic control during hospitalization on NOE outcome. 3. Observe trends in the incidence of the offending pathogens in regards to DM severity and glycemic control.