Byun YJ, Patel J, Nguyen SA, Lambert PR, et al.
World journal of otorhinolaryngology - head and neck surgery. Date of publication 2020 May 4;volume 7(4):296-302.
1. World J Otorhinolaryngol Head Neck Surg. 2020 May 4;7(4):296-302. doi:
10.1016/j.wjorl.2020.04.002. eCollection 2021 Oct.
Hyperbaric oxygen therapy in malignant otitis externa: A systematic review of
the literature.
Byun YJ(1)(2), Patel J(1), Nguyen SA(1), Lambert PR(1).
Author information:
(1)Department of Otolaryngology-Head and Neck Surgery, Medical University of
South Carolina, Charleston, SC, USA.
(2)University of Central Florida College of Medicine, Orlando, FL, USA.
OBJECTIVE: To review the role of adjuvant hyperbaric oxygen therapy (HBOT) in
the treatment of malignant otitis externa (MOE).
DATA SOURCES: PubMed, Scopus, Web of Science, Science Direct, and Cochrane
Library were searched for the following concepts: "hyperbaric oxygen" and
"malignant or necrotizing otitis externa."
METHODS: Studies were included if they contained (1) patients with reported
evidence of MOE, (2) employment of adjuvant HBOT, (3) details on patients'
medical condition, and (4) documented survival outcomes. Extracted information
included patient demographics, underlying medical conditions, infectious
etiology, signs and symptoms, medical and surgical treatments, duration of
medical treatment, mean follow up time, HBOT setting, number of HBOT sessions,
complications, survival rate, and all-cause mortality.
RESULTS: A total of 16 studies comprising 58 patients (mean age 68.0 years) were
included. Diabetes was present in 94.7% of cases and Pseudomonas spp (64.3%) was
the most common infectious agent. Cranial nerve VII was involved in 55.2% of
cases. Overall, the disease cure rate with adjuvant HBOT was 91.4% and all-cause
mortality was 8.6%. Among those who had cranial nerve VII involvement, 72.0% had
return of function and 93.8% of them survived.
CONCLUSION: HBOT may be an effective treatment option for refractory or advanced
MOE but its efficacy remains unproven due to lack of strong scientific evidence.
However, its therapeutic value should not be underestimated given good results
and few adverse events reported in this study.
© 2020 The Authors.
DOI: 10.1016/j.wjorl.2020.04.002
PMCID: PMC8486695
PMID: 34632343
