Treatment protocol:
Upon admission, all patients received empiric treatment comprising of quinolone or third generation cephalosporin. Further treatment was based on the pathogen’s sensitivity profile. In cases where no pathogen was isolated, empiric intravenous anti-PA antibiotic was continued. Anti-fungal treatment was initiated only in cases of positive cultures.
All patients underwent daily examination and local debridement. Granulation tissue was removed and sent for pathological evaluation in all patients. Indications for surgery were 1) no response to conservative treatment, as assessed by a senior otologist 2) new onset facial palsy or presence of facial nerve palsy not responding to treatment.