Stratification for malignant external otitis.

OBJECTIVE: To propose a CT-based method for early identification of severe cases of malignant external otitis (MEO) by correlating between initial CT findings and clinical course.

STUDY DESIGN AND SETTING: Eighteen MEO patients who underwent CT on admission were included in this retrospective study conducted at a tertiary center. The number and extent of anatomical areas involved according to CT were compared to clinical course severity.

RESULTS: The patients were categorized into two groups according to clinical course. There were 13 patients in the "nonsevere" group and 5 in the "severe." In six out of eight CT anatomical areas the "severe" group had significantly higher scores (P < 0.05 to P < 0.0005). The average number of areas involved in the "nonsevere" group was 2.9 and in the "severe" 5.4 (P < 0.0005).

CONCLUSION: We found a clear correlation between clinical course and initial CT findings in MEO patients. Based on these findings it may be possible to predict clinical course severity according to initial CT.