{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:54:42Z","timestamp":1775559282947,"version":"3.50.1"},"reference-count":27,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0022215126104277_sec1a\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malignant otitis externa is a life-threatening infection in which facial nerve palsy is a morbid complication. This TriNetX study identified predictors of facial nerve palsy in malignant otitis externa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0022215126104277_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis compared malignant otitis externa-only (\n                      <jats:italic>n<\/jats:italic>\n                      = 12 032) versus malignant otitis externa plus facial nerve palsy (\n                      <jats:italic>n<\/jats:italic>\n                      = 719) cohorts for demographics, biochemical markers and co-morbidities using\n                      <jats:italic>t<\/jats:italic>\n                      -tests and odds ratios (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0022215126104277_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Male gender (\n                      <jats:italic>p<\/jats:italic>\n                      = 4.65 \u00d7 10\n                      <jats:sup>\u221215<\/jats:sup>\n                      ) and Hispanic and\/or Latino ethnicity (17.66\n                      <jats:italic>vs<\/jats:italic>\n                      13.02 per cent,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0014) predicted facial nerve palsy. The significant biochemical markers were albumin, blood urea nitrogen (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 10\n                      <jats:sup>\u221218<\/jats:sup>\n                      ), glucose, erythrocyte sedimentation rate (ESR), creatinine, iron and activated partial thromboplastin time. The key co-morbidities were hypertension (odds ratio = 3.72,\n                      <jats:italic>p<\/jats:italic>\n                      = 6.95 \u00d7 10\n                      <jats:sup>\u221255<\/jats:sup>\n                      ), chronic kidney disease (odds ratio = 3.12,\n                      <jats:italic>p<\/jats:italic>\n                      = 1.44 \u00d7 10\n                      <jats:sup>\u221249<\/jats:sup>\n                      ), malnutrition (odds ratio = 3.44) and electrolyte imbalances (odds ratio = 2.59). Migraines and\/or headaches were non-significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0022215126104277_sec4d\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Male sex, Hispanic and\/or Latino ethnicity, hypoalbuminemia, elevated blood urea nitrogen and\/or glucose and\/or ESR, and co-morbidities (hypertension, chronic kidney disease, malnutrition) strongly predict facial nerve palsy in malignant otitis externa. Early risk factor management may prevent facial nerve palsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0022215126104277","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T10:19:44Z","timestamp":1767694784000},"page":"252-257","source":"Crossref","is-referenced-by-count":0,"title":["Predictive factors for facial nerve palsy in malignant otitis externa: a TriNetX data analysis"],"prefix":"10.1017","volume":"140","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1510-9490","authenticated-orcid":false,"given":"Huseyin","family":"Isildak","sequence":"first","affiliation":[{"name":"Stony Brook Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"S0022215126104277_ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041809"},{"key":"S0022215126104277_ref15","first-page":"413","article-title":"Chronic kidney disease and infection: mechanisms of increased susceptibility","volume":"26","author":"Chonchol","year":"2006","journal-title":"Semin Nephrol"},{"key":"S0022215126104277_ref22","first-page":"1396","article-title":"Uremia and immune dysfunction: implications for infection susceptibility","volume":"3","author":"Kato","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"S0022215126104277_ref6","first-page":"714","article-title":"Diabetes in the practice of otolaryngology","volume":"13","author":"Peled","year":"2019","journal-title":"Diabetes Metab Syndr"},{"key":"S0022215126104277_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90224-4"},{"key":"S0022215126104277_ref23","first-page":"3","article-title":"Electrolyte disorders in acute illness: implications for neurological outcomes","volume":"29","author":"Liamis","year":"2016","journal-title":"Eur J Intern Med"},{"key":"S0022215126104277_ref10","first-page":"4567","article-title":"Correlation between clinical prognostic markers glycated haemoglobin (HbA1c), ESR and CRP levels and the stage of disease in malignant otitis externa","volume":"74","author":"Chen","year":"2022","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"S0022215126104277_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24994"},{"key":"S0022215126104277_ref11","first-page":"v17","article-title":"The effect of inflammation on serum albumin levels","volume":"18","author":"Don","year":"2003","journal-title":"Nephrol Dial Transplant"},{"key":"S0022215126104277_ref21","first-page":"176","article-title":"The role of iron in infection and immunity","volume":"264","author":"Nemeth","year":"2015","journal-title":"Immunol Rev"},{"key":"S0022215126104277_ref9","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2939"},{"key":"S0022215126104277_ref4","doi-asserted-by":"publisher","DOI":"10.1038\/nri.2016.90"},{"key":"S0022215126104277_ref25","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121003856"},{"key":"S0022215126104277_ref16","first-page":"162","article-title":"Metabolic and nutritional consequences of severe infection","volume":"17","author":"Preiser","year":"2011","journal-title":"Curr Opin Crit Care"},{"key":"S0022215126104277_ref2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810396132"},{"key":"S0022215126104277_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s40985-016-0043-2"},{"key":"S0022215126104277_ref14","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-018-0052-0"},{"key":"S0022215126104277_ref12","first-page":"481","article-title":"Hypoalbuminemia in acute illness: a marker of severity and a target for intervention","volume":"15","author":"Gatta","year":"2012","journal-title":"Curr Opin Clin Nutr Metab Care"},{"key":"S0022215126104277_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813482107"},{"key":"S0022215126104277_ref27","first-page":"816","article-title":"Genetic diversity in Hispanic\/Latino populations: implications for disease susceptibility","volume":"43","author":"Rivas","year":"2011","journal-title":"Nat Genet"},{"key":"S0022215126104277_ref20","first-page":"E150","article-title":"Hepcidin and iron regulation in health and disease","volume":"94","author":"Ganz","year":"2019","journal-title":"Am J Hematol"},{"key":"S0022215126104277_ref1","unstructured":"1 TriNetX, LLC. 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In: https:\/\/www.trinetx.com [30 April 2025]"},{"key":"S0022215126104277_ref13","first-page":"246","article-title":"Malignant otitis externa: causes for various treatment responses","volume":"72","author":"Hollis","year":"2020","journal-title":"Indian J Otolaryngol Head Neck Surg"},{"key":"S0022215126104277_ref24","first-page":"1026","article-title":"Headache and neurological disease: a practical approach","volume":"24","author":"Friedman","year":"2018","journal-title":"Continuum (Minneap Minn)"},{"key":"S0022215126104277_ref8","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2010.0630"},{"key":"S0022215126104277_ref26","first-page":"1444","article-title":"Renoprotective effects of angiotensin-converting enzyme inhibitors in chronic kidney disease","volume":"368","author":"Strippoli","year":"2006","journal-title":"Lancet"},{"key":"S0022215126104277_ref5","first-page":"279","article-title":"How does testosterone influence immune responses?","volume":"62","author":"Trigunaite","year":"2015","journal-title":"Immunol Res"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215126104277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:58:33Z","timestamp":1775555913000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215126104277\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S0022215126104277"],"URL":"https:\/\/doi.org\/10.1017\/s0022215126104277","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}