Prognostic implications of therapy for necrotizing external otitis.
Prognostic implications of therapy for necrotizing external otitis.
复制标题
坏死性外耳炎治疗的预后意义。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
Panwalker Ap
中科院分区：
文献类型：
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作者：
Corey Jp;Levandowski Ra;Panwalker Ap
坏死性外耳炎是由铜绿假单胞菌引起的一种缓慢进行性耳道和颅底感染。用氨基糖苷和抗假单胞菌青霉素抗生素治疗可显著减少感染的延伸，降低相关颅神经损伤的严重程度，并限制疾病相关死亡率。当对疾病的类似阶段进行评估时，抗菌药物和手术联合治疗似乎比单独使用抗生素更有效。然而，侵入性手术可能会促进感染的传播，特别是在没有适当的抗生素治疗的情况下。当外耳炎存在超过两周时，特别是在局部清创和局部抗生素治疗后，应引起对该综合征的高度怀疑。糖尿病患者是风险最大的患者，积极使用全身性抗生素治疗应减少疾病扩展和减少多次外科手术的需要。
Necrotizing external otitis is a slowly progressive infection of the ear canal and basal skull caused by Pseudomonas aeruginosa. Treatment with aminoglycoside and antipseudomonal penicillin antibiotics significantly reduces extension of infection, decreases the severity of the associated cranial nerve injury, and limits disease-related mortality. Combined antimicrobial and surgical treatment appears to be more efficacious than antibiotics alone when evaluated for comparable stages of the disease. However, invasive surgical procedures may promote the spread of infection, particularly in the absence of appropriate antibiotic therapy. A high index of suspicion for the syndrome should be aroused when external otitis is present for longer than two weeks, especially after local debridement and topical antibiotic treatment. Aggressive use of systemic antibiotic therapy in diabetic patients, who are at greatest risk, should reduce disease extension and lessen the need for multiple surgical procedures.