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Diagnosis and treatment of necrotising otitis externa and diabetic foot osteomyelitis – similarities and differences

Published online by Cambridge University Press:  28 August 2018

C Peled ,
M Kraus  and
D Kaplan
C Peled*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
M Kraus
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
D Kaplan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
*
Author for correspondence: Dr Chilaf Peled, Department of Otolaryngology – Head and Neck Surgery, Soroka, University Medical Center, POB 151, Beer-Sheva, Israel E-mail: chilafp@gmail.com
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Abstract

Objective

Necrotising otitis externa is a severe inflammatory process affecting soft tissue and bone, mostly in diabetic patients. Diabetic patients are also at risk of diabetic foot osteomyelitis, another inflammatory condition involving soft tissue and bone. This review aimed to describe the similarities and differences of these entities in an attempt to further advance the management of necrotising otitis externa.

Method

A PubMed search was conducted using the key words ‘otitis externa’, ‘necrotising otitis externa’, ‘malignant otitis externa’, ‘osteomyelitis’ and ‘diabetic foot’.

Results and conclusion

The similarities regarding patient population and pathophysiology between necrotising otitis externa and diabetic foot osteomyelitis raise basic questions concerning the effects of long-standing diabetes on the external ear. The concordance between local swabs and bone cultures in diabetic foot osteomyelitis is less than 50 per cent. If this holds true also to necrotising otitis externa, the role of deep tissue cultures should be strongly considered. Similar to diabetic foot osteomyelitis, magnetic resonance imaging should be considered in selected necrotising otitis externa subgroups.

Keywords

Otitis ExternaDiabetes MellitusFoot UlcerOsteomyelitisNecrosis
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 9 , September 2018 , pp. 775 - 779
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr C Peled takes responsibility for the integrity of the content of the paper

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