Impact of stringent versus moderate glycaemic control on the outcome of necrotizing otitis externa

Sally Sameh Ahmed; Mohammed Abdelbadie Salem; Ahmed Abdoo Elzehzahy; Ahmed Hemdan

Sally Sameh Ahmed Department of Internal Medicine (Unit of Endocrinology, Diabetes and Metabolism), Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mohammed Abdelbadie Salem Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Ahmed Abdoo Elzehzahy Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Ahmed Hemdan Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Keywords: stringent, moderate, glycaemic control, necrotizing otitis externa

Abstract

Glycaemic control is an essential component in necrotizing otitis externa (NOE) management. The aim of this study was to compare the impact of stringent versus moderate glycaemic control on the outcome of NOE. A retrospective cohort study carried out among 94 diabetic patients with NOE divided into 2 groups A&B. Patients in group A had stringent glycaemic control while those in group B had moderate glycaemic control. The two groups were then compared to each other as regards age, gender, culture results, cranial nerve palsy, HbA1C level, inflammatory markers including ESR and CRP levels, duration of hospitalization and surgical intervention. Groups A and B comprised 41 and 53 patients respectively. Pseudomonas aeruginosa was significantly lower in group A (P-value 0.04). Cranial nerve palsy was significantly lower in group A (P-value 0. 04). The mean HbA1c level±SD was significantly lower in group A (P-value<0.001). The mean ESR level±SD after 2 weeks of medical treatment was significantly lower in group A (P-value<0.001). Similarly, the mean CRP level±SD after 2 weeks of medical treatment was significantly lower in the group A (P-value 0.03). Patients in group A were associated with significantly less hospital stay (P-value<0.001) and less need for surgical intervention (P-value 0.03). Despite the risk of hypoglycaemia, stringent glycaemic control appeared to improve the outcome of NOE in comparison to moderate glycaemic control.