Malignant Otitis Externa....

Dear Friends,
Continuing our discussion of Malignant Otitis Externa, we will appreciate unless a late stage of complications is reached ( which is pretty late in the course of the disease) there are hardly any definitive symptoms or signs of Malignant Otitis Externa which are specific for the disease.Mind it even the HPE Report just talks about chronic granulation tissue.
In such a scenario,Radionucleotide Scanning (Scintigraphy) helps in confirming the diagnosis.Technecium-99 bone scan shows increased uptake in the involved area - it is suggestive of increased bony metabolism..so a very sensitive test.The only problem is that the uptake remains high even after the disease is responding positively to the treatment.Here another radionucleotide ....Gallium-67 is very useful..its uptake is dependent on the response to the treatment.So repeated Gallium scan can be done to monitor the effectiveness to the treatment.In absence of the availability of these facilities, even an ESR is a good indicator of the resolution of the disease.