Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

References

    1. Smith ME, Hardman JC, Mehta N, Jones GH, Mandavia R, Anderson C, et al. Acute otitis externa: consensus definition, diagnostic criteria and core outcome set development. PLoS ONE. 2021;16(5):e0251395. - PMC - PubMed
    1. Wiegand S, Berner R, Schneider A, Lundershausen E, Dietz A. Otitis externa. Dtsch Arztebl Int. 2019;116(13):224–234. - PMC - PubMed
    1. Rosenfeld RM, Schwartz SR, Cannon CR, Roland PS, Simon GR, Kumar KA, et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. 2014;150(1 Suppl):S1–24. - PubMed
    1. Baoum SO, Mousa AAB, Alshammari MY, Alzaher ZS, Zahrani HM, Alhammad AH, et al. Epidemiology, risk factors and monitoring of acute otitis externa. Int J Commun Med Public Health. 2021;8(12):6155–6159.
    1. Wipperman J. Otitis externa. Prim Care. 2014;41(1):1–9. - PubMed

LinkOut - more resources