Imaging in the Diagnosis and Management of Necrotizing Otitis Externa: A Survey of Practice Patterns.

Imaging in the Diagnosis and Management of Necrotizing Otitis Externa: A Survey of Practice Patterns.

Otol Neurotol. 2018 Jun;39(5):597-601

Authors: Cooper T, Hildrew D, McAfee JS, McCall AA, Branstetter BF, Hirsch BE

Abstract
OBJECTIVE: To survey neurotologists and head and neck radiologists regarding use of imaging in the diagnosis and management of necrotizing otitis externa (NOE).
STUDY DESIGN: Cross-sectional survey study.
SETTING: Online survey distributed through email to specialty society membership lists.
PARTICIPANTS: Neurotologists and head and neck radiologists with membership in either the American Neurotology Society or The American Society of Head and Neck Radiology.
MAIN OUTCOME MEASURES: Responses to survey consisting of two demographic and seven clinically oriented questions related to the use of imaging in the diagnosis and management of NOE.
RESULTS: One hundred thirty-six participants responded to the survey. The imaging modality of choice in establishing the diagnosis of NOE selected by the respondents was computed tomography (CT) (37.5%) followed by technetium scintigraphy (21.3%). Magnetic resonance imaging (MRI) was the preferred investigation by 41.9% of participants for determining extent of disease. Gallium scanning was the imaging modality preferred by 32.4% of respondents for determining when to cease medical therapy. Ninety-five percent of participants responded that CT scans were always or frequently used in the diagnosis and management of NOE compared with 72.8% for MRI, 34.5% for gallium scans, and 34.2% for technetium scans.
CONCLUSIONS: There is considerable heterogeneity in the preferred imaging modalities used in the diagnosis and management of NOE. CT and MRI are the preferred contemporary modalities used by many physicians, demonstrating a shift away from the historic use of nuclear medicine scans.

PMID: 29738387 [PubMed - in process]

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