From the Research
Treatment Overview
The treatment for malignant otitis externa (MOE) in patients with Diabetes Mellitus (DM) involves a combination of measures to control the infection and manage the underlying diabetes. The key components of treatment include:
- Controlling diabetes mellitus 1, 2, 3, 4, 5
- Administering proper antibiotic therapy to fight the infection 1, 2, 3, 4, 5
- Debridement of necrotic tissue 1, 2
- Aggressive surgical management in some cases 1, 2, 5
- Hyperbaric oxygen therapy for patients with facial nerve palsy 1, 5
Antibiotic Therapy
The most common pathogen responsible for MOE is Pseudomonas aeruginosa 1, 2, 4, 5. Therefore, antibiotic therapy should be targeted against this bacterium.
Surgical Management
Surgical intervention may be necessary in cases where the disease is resistant to medical therapy or in patients with complications such as facial nerve palsy 1, 2, 5.
Monitoring and Prognosis
The response to therapy can be monitored through normalization of erythrocyte sedimentation rate, control of diabetes mellitus, and improvement of computed tomography and radioisotope scanning 1. The presence of certain factors, such as diabetes, facial nerve palsy, positive CT scan, and age above 70, can predict poor outcome and highlights the need for prolonged, vigorous treatment 5.