Abstract
Objective
To analyze management outcome of necrotizing otitis externa in a tertiary referral center.
Methods
We retrospectively reviewed patients who were admitted due to necrotizing otitis externa in UKMMC from January 2002 to February 2009.
Results
A total of seven patients were seen during the study period. There were 6 males and 1 female with age ranging from 31 to 88 years (mean age 55.4). Six were diabetic and 66.7% were on insulin therapy. All of them presented with excruciating otalgia, ear discharge and reduced hearing. Two of the patients developed facial nerve palsy. The causative organism was almost always Pseudomonas aeruginosa (77.8%), although Diptheroids and Aspergillus flavus were isolated. All patients had raised ESR ranging from 37 to 111. Pure tone audiogram showed 57% had mixed hearing loss, 28% had conductive hearing loss and 2% had profound sensorineural hearing loss on affected ear. All patients underwent high resolution computed tomography of temporal bone. Only 1 patient had bone scan. Most of the patients were treated with intravenous ciprofloxacin for about 2 weeks and long term oral ciprofloxacin for at least 3 to 6 months.
Conclusion
Necrotizing otitis externa occured in elderly and uncontrolled diabetic patient. Pseudomonas aeruginosa was the most common organism cultured and medical treatment with long term ciprofloxacin showed complete resolution of disease and good outcome. (Rawal Med J 2011;36: 143-146).

Key words: Otitis externa, pseudomonas aeruginosa, diabetes mellitus.