Five succinct key points:
1. Patients with NOE often have medical comorbidities which require concurrent optimization to improve outcomes.
2. A novel grading system of otoscopy and CT scan findings presented herein provides an objective measure and common language with which to describe extent of NOE.
3. Initial outcomes data suggest selected patients make a good recovery with short course intravenous antimicrobial therapy as compared to those on long course intravenous antimicrobial therapy but an appropriately powered randomized trial is needed to confirm non-inferiority.
4. Limited surgical debridement provides an opportunity for histological and microbiological testing in cases refractory to initial management or persistent physical signs.
5. Multidisciplinary involvement – in particular with microbiology and radiology is essential to optimize management.