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Biocompatible implantable antimicrobial release for necrotizing external otitis

Published online by Cambridge University Press:  29 June 2007

E. J. Ostfeld  and
A. Kupferberg
E. J. Ostfeld*
Affiliation:
Departments of Otolaryngology and Orthopaedics, Hillel Yaffe Medical Center, Hadera, Israel.
A. Kupferberg
Affiliation:
Departments of Otolaryngology and Orthopaedics, Hillel Yaffe Medical Center, Hadera, Israel.
*
Otolaryngology, Hillel Yaffe Med. Ctr. Hadera 38100, Israel.
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Abstract

The efficacy of a biocompatible, surgically implantable, antimicrobial release system (IARS) as the exclusive antimicrobial therapy of necrotizing external otitis (NEO) was evaluated in six NEO patients. Gentamicin incorporated polymethyl-methacrylate beads were implanted, following surgical debridement and were removed two months later. Post-implantation alleviation of clinical symptoms: pain, periauricular tissue swelling, otorrhoea, eradication of pseudomonal infection (100 per cent) and substantially shortened hospitalization (4–15 days) were the salient results of this therapeutic modality. Three patients recovered. Two patients who died, one of sudden cardiac arrest and the other of paralytic ileus, 15 and 60 days postoperatively while the beads were still implanted, were symptomless. Recurrence was seen in one patient with early bead extrusion. Ipsilateral sensorineural hearing loss (one patient) and external meatal stenosis were the main complications. IARS appears to offer an effective alternative to long-term systemic antibiotic administration for the eradication of NEO-pseudomonal infection in patients who are sensitive, develop resistance, or when quinolone medical treatment has failed or is contra-indicated.

Keywords

Otitis externamalignant (necrotising)Gentamicin
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 4 , April 1991 , pp. 252 - 256
Copyright
Copyright © JLO (1984) Limited 1991

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References

Couldery, A. D., Sharma, P. L. (1988) Nectrotizing otitis externa (a new aid to management). Journal of Laryngology and Otology, 102: 713–714.CrossRefGoogle Scholar
Dingeldein, E. (1981) Bacteriological studies in patients treated withy gentamicin-PMMA beads. In Local antibiotic treatment in osteomyelitis and soft tissue infections; Proceedings of a Symposium (van Rens, T., Kayser, F. H., eds) p. 18, Excerpta Medica, International Congress Series; Amsterdam.Google Scholar
Gilbert, D. M., Tice, A. D., Marsh, P. K., Craven, B. C., Breheim, L. D. (1987) Oral ciprofloxacin therapy for chronic contiguous osteomyelitis caused by aerobic gram-negative bacilli. American Journal of Medicine, 82 (Supplement 4A): 254–258.Google ScholarPubMed
Greenberg, R. M., Tice, A. D., Marsh, P. K., Craven, P. C., Reilly, P. M., Bollinger, M., Weinandt, L. A. (1987) Randomized trial of ciprofloxacin compared with other anti-microbial therapy in the treatment of osteomyelitis. American Journal of Medicine, 82 (Supplement 4A): 266–269.Google Scholar
Grieben, A. (1980) Results of Septopal in more than 1500 cases of bone and soft tissue infections: a review of clinical trials. Journal of Bone and Joint Surgery, 62(B): 275.Google Scholar
Joachims, H., Danino, J., Raz, M. (1988) Malignant external otitis: treatment with fluroquinolones. American Journal of Otolaryngology, 9: 102–105.CrossRefGoogle Scholar
Kimmelman, C. P., Lucente, F. E. (1989) Use of ceftazidine for malignant external otitis. Annals of Otology, Rhinology and Laryngology, 98: 721–725.CrossRefGoogle Scholar
Klemm, K. W. (1988) Gentamicin-PMMA chains (Septopal Chains) for the local antibiotic treatment of chronic osteomyelitis. Reconstructive Surgery and Traumatology, 20: 11–35.Google ScholarPubMed
Kraus, D. H., Rehm, S. J., Kinney, S. E. (1988) The evolving treatment of necrotizing external otitis. Laryngoscope, 98: 934–939.CrossRefGoogle ScholarPubMed
Leggett, J. M., Prendergast, (1988) Malignant external otitis: the use of oral ciprofloxacin. Journal of Laryngology and Otology, 102: 53–54.CrossRefGoogle ScholarPubMed
Levy, R., Shpitzer, T., Shvero, J., Pitlik, S. D. (1990) Oral ofloxacin as treatment of malignant external otitis. Laryngoscope, 100: 548–551.CrossRefGoogle ScholarPubMed
Morrison, G. A., Bailey, C. M. (1988) Relapsing malignant otitis externa successfully treated with ciprofloxacin. Journal of Laryngology and Otology, 102: 872–876.CrossRefGoogle ScholarPubMed
Muller, K. H. (1980) Experience with local antibiotic therapy with post-traumatic octeomyelitis by means of gentamicin polymethylmethacrylate. Journal of Bone and Joint Surgery, 62-B: 275.Google Scholar
Nix, D. E., Curribo, T. J., Juritzky, B., Devito, J. M., Schentag, J. J. (1987) Oral ciprofoxacin in the treatment of serious soft tissue and bone infections. American Journal of Medicine, 82 (Supplement 4A): 146–153.Google Scholar
Norrby, S. R. (1989) Ciprofloxacin in the treatment of acute and chronic osteomyelitis: a review. Scandinavian Journal of Infectious Diseases, Supplement 60: 74–78.Google ScholarPubMed
Ostfeld, E. (1989) Malignant external otitis, guidelines to surgical management. In Proceedings of the Third International Conference on Cholesteatomy and Mastoid Surgery. (Tos, M., Thomsen, J., Peitersen, E., eds.) pp. 617–620, Kugler & Ghedini Publications, Amsterdam.Google Scholar
Ostfeld, E., Aviel, A., Pelet, D. (1981 a) Malignant external otitis: the diagnostic value of bone scintigraphy. Laryngoscope, 91: 960–964.CrossRefGoogle ScholarPubMed
Ostfeld, E., Segal, M., Czernobilsky, B. (1981b) Malignant external otitis: early histopathogenic changes and pathogenic mechanism. Laryngoscope, 91: 965–970.CrossRefGoogle Scholar
Perry, C. R., Ritterbush, J. K., Rice, S. H., Davenport, K., Burdge, R. E. (1986) Antibiotics delivered by an implantable drug pump. American Journal of Medicine, 80 (Supplement 6B): 222–227.CrossRefGoogle ScholarPubMed
Rahm, V., Schacht, P. (1989) Safety of ciprofloxacin: a review. Scandinavian Journal of Infectious Diseases, Supplement 60: 120–128.Google ScholarPubMed
Rubin, J., Stoehr, G., Yu, V. L., Muder, R. R., Matador, A., Kamerer, D. B. (1989) Efficacy of oral ciprofloxacin plus rifampin for treatment of malignant external otitis. Archives of Otolaryngology Head and Neck Surgery, 115: 1063–1069.CrossRefGoogle ScholarPubMed
Sabater, F., Mensa, J., Domeneck, J., Louca, M., Carulla, M. (1988) Necrotizing external otitis treated with ciprofloxacin. Journal of Laryngology and Otology, 102: 606–607.CrossRefGoogle ScholarPubMed
Sadé, J., Lang, R., Goshen, S., Kitzes-Cohen, R. (1989) Ciprofloxacin treatment of malignant external otitis. American Journal of Medicine, 87 (Supplement 5A): 138S–141S.CrossRefGoogle ScholarPubMed
Siegenthaler, W. E., Bonetti, A., Lutky, R. (1986) Aminoglycoside antibiotics in infectious diseases. American Journal of Medicine, 80 (Supplement 6B): 2–14.CrossRefGoogle ScholarPubMed
Slama, T. G., Misuisky, J., Sklar, S. (1987) Oral ciprofloxacin therapy for osteomyelitis caused by aerobic gram-negative bacilli. American Journal of Medicine, 82 (Supplement 4A): 259–262.Google Scholar
Strauss, M., Aber, R. C., Conner, G. H., Baum, S. (1982) Malignant external otitis: long term (months) antimicrobial therapy. Laryngoscope, 92: 397–402.CrossRefGoogle ScholarPubMed
Wahling, H., Dingeldein, E. (1980) Antibiotics and bone cements; experimental and clinical long-term observations. Acta Orthopedica Scandinavica, 51: 49–56.CrossRefGoogle Scholar
Wahling, H., Dingeldein, E., Bergmonn, R., Reuss, K. (1978) The release of gentamicin from polymethylmethacrylate beads. Journal of Bone and Joint Surgery, 60: 270–275.Google Scholar