What are comorbid conditions associated with malignant otitis externa (MEO)?

Updated: Apr 13, 2020
  • Author: Brian Nussenbaum, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Patients with malignant external otitis (MEO) almost always have diabetes, often with other multiple medical problems. [9] During the course of therapy, Chandler found some deaths related to pneumonia, uremia, myocardial infarction, strokes, and liver failure. Franco-Vidal showed that patients with systemic immunodeficiencies had a worse prognosis. [6]

A nationwide, population-based case-control study from Taiwan, by Yang et al, supported the association between diabetes and malignant external otitis (MEO). The investigators reported that 54.8% of patients with MEO had previously diagnosed diabetes, compared with 13.9% of controls. The adjusted odds ratio for previously diagnosed diabetes in the presence of MEO was 10.07. [10]

A study by Sylvester et al analyzing 8300 cases of inpatient malignant external otitis from the National (Nationwide) Inpatient Sample database (2002-2013) found that diabetes mellitus in adult and elderly patients was associated with a greater number of comorbidities, longer hospitalizations (5.5 days vs 4.0 days in patients without diabetes), and higher hospital charges ($25,118 vs $17,039 in patients without diabetes). However, in-hospital mortality rates were not significantly greater in patients with diabetes than in those without it (0.6% vs 0.5%, respectively). [11]

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