నైరూప్య

The Role of Hyperbaric Oxygen Therapy in Necrotizing Otitis Externa: 8 Case Reports Review

Borges-Costa Joana, Abreu Pereira Diogo, Duarte Delfim, Viana Miguel, Fernandes Tiago

Introduction: Malignant or necrotizing otitis externa (NOE) is an invasive infection of the external ear canal that primarily affects elderly diabetic or immunocompromised patients. The role of hyperbaric oxygen therapy (HBO) in NOE management is not well established but some authors believe that HBO is a valuable and beneficial treatment method and recommend its use in NOE for refractory skull base osteomyelitis and intracranial involvement. This study’s aim was to present our NOE’s management experience, describing 8 case reports and correlating the clinical outcomes with HBO treatment.

Methods: This observational study is about NOE’s patients treated with HBO in Pedro Hispano Hospital during the last 10 years (2007-2016). All patients’ records were reviewed.

Results: During the studied period, 8 patients with NOE diagnosis were admitted to our hospital for investigation and HBO-treatment. Local and systemic antibiotic treatment and HBO treatment was proposed for all patients and, although only 5 patients have completed the HBO-40 sessions, we were able to control the disease in most of them.

Conclusion: There is an apparent beneficial effect of HBO on complicated and refractory NOE cases. It’s gradually gaining acceptance as a useful adjunctive therapy and, considering NOE as a potentially fatal disease, the current recommendations state that HBO should be used whenever a therapeutic pressure chamber is available.