Podcast
Questions and Answers
Why are individuals with diabetes mellitus at a higher risk of developing malignant otitis externa (MOE)?
Why are individuals with diabetes mellitus at a higher risk of developing malignant otitis externa (MOE)?
- Microangiopathy in the ear canal and altered cerumen pH may promote infection. (correct)
- Diabetes causes deterioration of the ossicles, creating an entry point for infection.
- The increased vascularity in the ear canal of diabetic patients directly facilitates bacterial entry.
- The reduced blood sugar levels in diabetics promotes the proliferation of *P. aeruginosa*.
A patient is diagnosed with malignant otitis externa (MOE). Initial treatment focuses on controlling the infection, but further investigation is needed to understand underlying risk factors. Which condition should be the primary focus of investigation?
A patient is diagnosed with malignant otitis externa (MOE). Initial treatment focuses on controlling the infection, but further investigation is needed to understand underlying risk factors. Which condition should be the primary focus of investigation?
- Hypothyroidism
- Diabetes mellitus (correct)
- Hypercholesterolemia
- Cardiovascular disease
How does progressive necrotizing otitis externa (malignant otitis externa) typically spread from the external auditory canal (EAC) to the skull base?
How does progressive necrotizing otitis externa (malignant otitis externa) typically spread from the external auditory canal (EAC) to the skull base?
- Via the fissures of Santorini and the tympanomastoid suture. (correct)
- Along the path of the arteries supplying the ear.
- Through the pneumatized tracts of the temporal bone.
- Through the Eustachian tube to the middle ear and then to the skull base.
Progressive necrotizing otitis externa (malignant otitis externa, MOE) is characterized by all of the following except:
Progressive necrotizing otitis externa (malignant otitis externa, MOE) is characterized by all of the following except:
A patient with HIV/AIDS presents with symptoms suggestive of malignant otitis externa (MOE). While Pseudomonas aeruginosa is the most common causative agent, what implication does the patient's immunocompromised status have on potential causative organisms?
A patient with HIV/AIDS presents with symptoms suggestive of malignant otitis externa (MOE). While Pseudomonas aeruginosa is the most common causative agent, what implication does the patient's immunocompromised status have on potential causative organisms?
Flashcards
Progressive Necrotizing Otitis Externa (MOE)
Progressive Necrotizing Otitis Externa (MOE)
Aggressive infection of the EAC, mastoid, and skull base, starting in the soft tissues and spreading via fissures and sutures.
Typical MOE Patient Profile
Typical MOE Patient Profile
Elderly individuals with diabetes are the most common group affected by malignant otitis externa (MOE).
Most common organism in MOE
Most common organism in MOE
P. aeruginosa is the most common bacterial cause, accounting for over 90% of cases.
Study Notes
- Progressive necrotizing OE, classically known as malignant otitis externa (MOE), is an aggressive and potentially life-threatening infection affecting the EAC, mastoid, and skull base.
- The infection starts in the EAC soft tissues, spreading to the skull base through the fissures of Santorini and to the stylomastoid and jugular foramina via the tympanomastoid suture.
- Unlike other temporal bone infections, MOE does not spread through pneumatized tracts, and the middle ear is rarely involved until late stages.
- Spread to the dural sinuses occurs via venous channels and facial planes.
- MOE is rare, predominantly affecting elderly patients with diabetes.
- Glucose intolerance is present in up to 90% of MOE patients.
- Proposed reasons for the correlation between MOE and diabetes include microangiopathy in the ear canal and increased cerumen pH in diabetics.
- MOE has also been observed in other immunocompromised conditions, including myeloid malignancies, pharmacologic immunosuppression, and HIV/AIDS.
- Rarely, MOE occurs in immunocompetent patients.
- P. aeruginosa is the most common causative organism in MOE, accounting for over 90% of cases.
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