Objective: Despite studies reporting a possible association between malignant otitis externa (MOE) and diabetes, there are no large-scale population-based empirical studies. This nationwide, population-based case-control study explored the association of MOE occurrence with previously diagnosed diabetes. Methods: Data were retrieved from Taiwan’s National Health Insurance Research Database, 753 patients with MOE (cases) and 2 259 propensity score-matched patients without MOE (controls). Multiple logistic regressions were conducted to examine the association of MOE with previously diagnosed diabetes. Results: In total, 728 (24.2%) out of 3 012 sample patients had diabetes prior to the index date. Chi-square test revealed a significant difference in diabetes prevalence among cases and controls (54.8% vs 13.9%, p < 0.001). Simple logistic regression showed the odds ratio for prior diabetes among cases versus controls was 7.50 (95% CI, 6.22~9.03). The adjusted odds ratio of prior diabetes for cases versus controls was 10.07 (95% CI, 8.15~12.44) after adjusting for patient demographics and medical co-morbidities. Conclusions: This study found an association between MOE and diabetes. One clinical practice implication of our study is that when a patient with diabetes complains of otalgia or otorrhea, and physical examination shows swelling of the ear canal or granulation growth, physicians should consider the possibility of MOE.

Original languageEnglish
Pages (from-to)585-590
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Issue number6
Publication statusPublished - Jun 1 2020


  • diabetes
  • epidemiology
  • malignant otitis externa
  • Bacterial Infections/epidemiology
  • Diabetes Mellitus/epidemiology
  • Prevalence
  • Humans
  • Middle Aged
  • Logistic Models
  • Male
  • Otitis Externa/epidemiology
  • Hospitalization
  • Case-Control Studies
  • Taiwan/epidemiology
  • Aged, 80 and over
  • Female
  • Aged
  • Odds Ratio

ASJC Scopus subject areas

  • Otorhinolaryngology


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