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Examining the utility of nuclear medicine imaging in the diagnosis and management of necrotising otitis externa

The primary objective of this study was to assess whether combination modality imaging (CT, and/or Technetium/Gallium) had any additional benefits over single modality imaging (CT) in the diagnosis and management of NOE. Combination modality imaging, in patients with a negative CT but raised clinical suspicion of NOE, did infer additional benefit over single modality imaging using CT. Gallium scanning, used to determine treatment end, was poorly representative of residual disease presence, with clinical assessment favoured instead. This study supports the use of Technetium nuclear imaging in a subset of patients with NOE; in particular, those with a high clinical suspicion of NOE but a negative initial CT, as a mean of potentially deescalating treatment. It does not support the use of Gallium imaging.