Objectives: To evaluate the risk of sensorineural hearing loss (SNHL) after mastoidectomy in patients with acute mastoiditis (AM) and compare patients who received surgical versus conservative treatment. Methods: A retrospective cohort study of medical records of all patients who were diagnosed with AM at Soroka medical center between the years 2005-2020 and had an available hearing test. Data included demographics, clinical characteristic, comorbidities, and a pure tune audiometry conducted in our institution after recovery. Hearing loss (HL) was defined as a decrease of 15 dB or more in a given frequency. HL was categorized as mild (25-40 dB decrease), moderate (41-70) or severe (71db<). Frequencies range was categorized as Low (<500 Hz), middle (501-2000 HZ) or high (>2001) pitch. We divided the patients to two groups; patients who received conservative treatment and patients who underwent surgery. Results: A total of 24 patients met the inclusion/exclusion criteria, 12 underwent surgery (mean age 20.2 m) and 12 received conservative treatment (mean age 20.1 m). A definite CHL of 10 to 20 dB could be diagnosed in 3 of the 5 patients in each group, who had bone conduction thresholds measured. SNHL was not observed in any of the patients old enough to have bone conduction tested Conclusions: This is the first study to examine HL of children following AM. From our limited study it seems that the disease itself as well as mastoidectomy is not a risk factor for developing SNHL later in life.

Introduction: Although the association between necrotizing otitis externa (NOE) and diabetes mellitus (DM) is well known, there is little knowledge in regards to the effects of DM and glycemic control (preadmission and during hospitalization) on the outcome of NOE. The aim of the study was to determine the effects of DM duration and preadmission glycemic control, and in-hospital glycemic control on NOE severity. Methods: A retrospective case series analysis, including all patients between the years 1990-2018 hospitalized due to NOE were included in the study. Data collected included NOE disease characteristics, duration of DM, DM associated comorbidities, glycated hemoglobin (HbA1c), urine micro-albumin and in-hospital blood glucose measurements. Disease severity was defined based on duration of hospitalization (above or below 20 days) and need for surgery. Results: Eighty nine patients were included in the study. Eighty three patients (94.3%) had DM. Preadmission HbA1c was 8.13% (5.8%-12.6%). Forty nine patients (65.5%) had mean blood glucose of ≥140mg\dL and 26 patients (34.5%) had ≤ 140mg/dL. DM duration was 157.88 months among NOE patients who required surgery, and 127.6 months among patients who were treated conservatively (p-value 0.25). HbA1c in patients hospitalized < 20 days was 7.6%, and 8.7% among NOE hospitalized ≥ 20 days (p-value 0.027). Seven patients with mean blood glucose of ≤140mg\dL had Pseudomonas Aeruginosa (PA-NOE) (26.7%), in comparison to 25 patients (51.0%) with mean blood glucose measurement of ≥140mg\dL (p=0.045). Conclusions: HbA1c levels at admission are associated with longer hospitalization duration among NOE patients. High mean blood glucose during hospitalization was associated with a higher likelihood for a PA infection, however it had no effect on disease outcome.