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.