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. 2023 Dec;75(4):3277-3287.
doi: 10.1007/s12070-023-03939-3. Epub 2023 Jun 20.

The Association Between Malignant Otitis Externa and Diabetes Mellitus in Africa: A Systematic Review

Taoreed Adegoke Azeez  1 , Adekunle Kazeem Adeagbo  2
Affiliations

The Association Between Malignant Otitis Externa and Diabetes Mellitus in Africa: A Systematic Review

Taoreed Adegoke Azeez et al. Indian J Otolaryngol Head Neck Surg. 2023 Dec.

Abstract

Diabetes mellitus is one of the risk factors for malignant otitis externa. There are very few studies on the disease in Africa and there is a need to pool the prior studies to highlight the characteristics of the disease. The study type is a systematic review and the PRISMA guidelines were followed. Using the appropriate terms, relevant medical databases were systematically searched. Thirty-two studies met the eligibility criteria with a total sample size of 848, who were mainly elderly. Diabetes mellitus was present in 94% of the participants. Average duration of diabetes diagnosis in the participants was 12.4 years. The pooled HbA1c was 9.8%. The most common symptoms were otalgia (96.1%), otorrhoea (75.8%) and hearing loss (56.1%). Pseudomonas was the most common isolate (72%). Fluoroquinolones and the 3rd-generation cephalosporins were the preferred antibiotics. The pooled cure rate from antimicrobial usage was 76.2%. In addition to medications, 24.6% of the affected individuals required debridement. About 1.6% of the participants died from malignant otitis externa. Malignant otitis externa is associated with poorly controlled diabetes. Pseudomonas is the most common cause and a significant proportion gets cured with prolonged antibiotherapy.

Keywords: Africa; Complications; Diabetes mellitus; Malignant otitis externa; Systematic review.

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Conflict of interest statement

Conflict of interestThe authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Classification of otitis externa
Fig. 2
Fig. 2
The PRISMA flow diagram
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Fig. 3
Frequency of the ears involved in the infection
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Fig. 4
Diagnostic imaging procedures
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Fig. 5
Pattern of anti-microbial usage
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Fig. 6
Forest plot on the frequency of diabetes in malignant otitis externa
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Fig. 7
Funnel plot
See this image and copyright information in PMC

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