What is the mortality rate in 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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Answer

Chandler reported a mortality rate of 50% in the original series. The mortality rate has decreased to 20% with the introduction of appropriate antibiotics, improved imaging modalities, and increased awareness of the disease.

Most current studies report a mortality rate of less than 10%, but mortality remains high for patients with cranial neuropathies (other than VII), intracranial complications, or with irreversible systemic immunosuppression.

A retrospective clinical study investigated the prognostic value of serial temporal bone MRI follow-up patterns in patients with necrotizing otitis externa. The most common finding was retrocondylar fat infiltration, which was also the earliest change seen. The patients with combined extension patterns (50%) had significantly lower overall survival compared with the patients with limited extension patterns or single extension patterns, suggesting that combined extension patterns, versus single or limited extension patterns, may be a poor prognostic factor in patients with necrotizing otitis externa. [16]


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