Regarding Necrotizing otitis externa, all are true except

It is an inflammatory condition caused by Pseudomonas infection, usually in the elderly diabetics or in those on immunosuppressive drugs. There will be excruciating pain and granulations in the ear canal. Treatment consists of Control of diabetes Toilet of the ear canal Antibiotic treatment It patient is not responsive, culture and sensitivity of ear discharge should guide the surgeon. Prolonged antibiotic treatment has replaced radical surgery and resections done earlier for this condition. ( Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 55)