{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T22:55:28Z","timestamp":1757631328064,"version":"3.44.0"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":71,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Necrotizing otitis externa (NOE), also known as malignant otitis externa (MOE), is a severe infection that begins in the external auditory canal and can extend to adjacent tissues and bone. It primarily affects elderly, diabetic, and immuno-compromised patients. Despite the advancements in antibiotics and surgical interventions, NOE remains a condition with significant morbidity and mortality.<\/jats:p><jats:p>To evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as an adjunctive treatment for NOE, focusing on clinical outcomes and the potential benefits in refractory or advanced cases.<\/jats:p><jats:p>We conducted a comprehensive literature search on the PubMed\/MEDLINE and Cochrane Library databases for articles published from January 1980 to December 2023. The search terms included hyperbaric oxygen therapy, necrotizing otitis externa, and refractory otitis. A total of 8 studies met the inclusion criteria, comprising case reports, observational studies, and case series. Study quality was assessed through the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale.<\/jats:p><jats:p>The results indicate that HBOT shows promise in the treatment of NOE, with several studies reporting complete resolution of infection and prevention of recurrence, especially in refractory cases.<\/jats:p><jats:p>The current evidence is insufficient to establish HBOT as a standard treatment for NOE; however, its potential benefits in improving clinical outcomes and reducing morbidity are significant. High-quality research, including randomized controlled trials, is necessary to validate the role of HBOT in NOE treatment. Where hyperbaric facilities are accessible, HBOT should be considered for refractory NOE cases.<\/jats:p>","DOI":"10.1055\/s-0045-1809432","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T23:16:14Z","timestamp":1757546174000},"page":"001-007","source":"Crossref","is-referenced-by-count":0,"title":["Advancements in the Treatment of Necrotizing Otitis Externa with Hyperbaric Oxygen: A Systematic Review"],"prefix":"10.1055","volume":"29","author":[{"given":"Hassan Al","family":"Bazzal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Al Rayyan Hospital, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firas","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine and Medical Sciences, University of Balamand, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Tlais","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine and Medical Sciences, University of Balamand, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5266-3690","authenticated-orcid":false,"given":"Yehya","family":"Tlaiss","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Faculty of Medicine and Medical Sciences, University of Balamand, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"ref1","volume-title":"Necrotizing (Malignant) Otitis Externa","author":"M S Al Aaraj"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"220113908","DOI":"10.1136\/bcr.02.2011.3908","article-title":"Skull based osteomyelitis due to postsurgery malignant otitis externa presenting 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