Surgical consideration and practical difficulty in malignant otitis externa: a systematic review.

PURPOSE: This systematic review aims to explore the role of surgery in managing Malignant Otitis Externa (MOE) by analyzing surgical considerations, treatment duration, responses, and patient outcomes.

METHODS

A comprehensive search was conducted across PubMed, Science Direct, Google Scholar, and Cochrane Library databases between 2003 and February 2023. Studies meeting inclusion criteria detailed MOE cases, patient medical profiles, surgical procedures undertaken, and treatment outcomes. Selection criteria emphasized surgical aspects and patient-related outcomes in MOE.

RESULTS

Twenty-two articles published from 2006 to 2023, encompassing 901 predominantly male participants, were included. Studies fell into quantitative descriptive (e.g., case series) and non-randomized quantitative categories (e.g., cohort studies). Surgery was primarily performed due to failed conservative treatments, complications like skull base osteomyelitis, and disease progression. Surgical interventions, notably debridement and mastoidectomy (n = 15), were detailed, with varied survival and mortality rates among studies.

CONCLUSION

Prompt identification and effective management are crucial for MOE, a rapidly advancing condition. Surgical intervention emerged as the preferred treatment option for critically affected MOE patients, especially in cases of failed conservative measures, complications, and disease progression.