Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa

BACKGROUND: Malignant, or necrotising, otitis externa is a potentially fatal infection of the external ear canal and surrounding soft tissue and bone. It may be complicated by involvement of cranial nerves, principally the facial nerves and the contents of the jugular foramen. It is an uncommon condition mainly found in the elderly or in diabetics.

OBJECTIVES: To assess the effectiveness of adjunctive hyperbaric oxygen treatment for malignant otitis externa.

SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2003), MEDLINE (January 1966 to April 2004) and EMBASE (January 1985 to April 2004) with pre-specified terms. The date of the last search was 5th April 2004.

SELECTION CRITERIA: Randomised controlled trials, involving adults, undergoing hyperbaric oxygen therapy in malignant otitis externa.

DATA COLLECTION AND ANALYSIS: No identified articles described randomised controlled trials of hyperbaric oxygen therapy in the treatment of malignant otitis externa.

MAIN RESULTS: Due to the lack of data no results could be presented.

AUTHORS' CONCLUSIONS: No clear evidence exists to demonstrate the efficacy of hyperbaric oxygen therapy when compared to treatment with antibiotics and/or surgery. No data were found to compare rates of complication between the different treatment modalities. Further research is required.