International Journal of Otorhinolaryngology and Head and Neck Surgery | August 2021 | Vol 7 | Issue 8 Page 1306 International Journal of Otorhinolaryngology and Head and Neck Surgery Antony S et al. Int J Otorhinolaryngol Head Neck Surg. 2021 Aug;7(8):1306-1312 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Original Research Article A study on correlation between clinical prognostic markers glycated hemoglobin, erythrocyte sedimentation rate and C-reactive protein levels and the stage of disease in malignant otitis externa Subin Antony*, Anita Ross, Deepthi Satish INTRODUCTION Malignant otitis externa (MOE) is an aggressive and potentially life-threatening infection which affects the soft tissues of the external ear and surrounding structures and has the propensity to rapidly spread to the skull base and the periosteum. 1 In 1836 the first case was reported in the literature and because of its high mortality the term ‘malignant otitis externa’ was coined in 1968. 2,3 MOE is a clinical diagnosis made on the basis of pain, exudate, granulations and edema of the external auditory canal often supported by a positive bone scan and intraoperatively the presence of micro abscesses. The CRP and ESR levels are nonspecific measures of inflammation that are significantly elevated in untreated cases and are useful parameters which is used to measure response to treatment. The ESR is often over 100 mm/hour. 11 ABSTRACT Background: Objectives of the study were to establish a clinical correlation between the stages of MOE and biochemical markers namely glycated Hb (HbA1c), C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels, to identify improvement in clinical symptomology in MOE following treatment and to correlate with the duration of diabetes mellitus with treatment outcome. Methods: Patients with diabetes mellitus, otalgia and ear discharge presenting to ENT OPD were subjected to detailed history and clinical examination. Otoscopic examination was done. Pus from the EAC was taken for culture and sensitivity. Baseline glycated Hb, ESR and CRP levels and HRCT temporal bone in axial and coronal planes was done. According to clinical findings and CT findings the patients were staged using chandlers staging. Patients were followed up after 1 st and 2 nd month and otoscopic examination with blood tests was repeated and staged accordingly Results: Fall in the levels of glycated HbA1c serves as a good prognostic indicator of the disease. Duration of diabetes has no significant impact on the disease prognosis. Most common etiologic agent is Pseudomonas aeruginosa. In spite of improvement in clinical features and inflammatory parameters there was no improvement in clinical staging with treatment. There was a significant fall in ESR and CRP values after treatment for 2 months with antibiotics and analgesics. Conclusions: The study highlights the need to control infection with medical line of treatment which can be monitored by ESR, CRP and glycated HbA1c and that the role for surgical management is limited for stage 1, 2 and 3. Keywords: Malignant otitis externa, Positron emission tomography-computerized tomography, Single photon emission computed tomography, Skull base osteomyelitis. Department of otorhinolaryngology, St. John’s medical college hospital Bangalore, Karnataka, India Received: 01 June 2021 Revised: 03 July 2021 Accepted: 05 July 2021 *Correspondence: Dr. Subin Antony, E-mail: subin.antony660@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20212899