Management of Mycotic Otitis Externa: A Clinicomycological Study

Abstract

Introduction: Fungi are eukaryotic heterotropic organisms. In otolaryngology, mycotic otitis externa is one of the most common infection affecting external ear canal. The predisposing causes for otomycosis are mostly preventable or adequately controlled by medical treatment. It is important to evaluate the predisposing factors elaborately and economical mode of treating the disease adequately. Aim: To evaluate the predisposing factors, clinical features and management of mycotic otitis externa. Materials and Methods: The present longitudinal study was conducted in the Department of Otorhinolaryngology, Shri Vasantrao Naik Government Medical College, Yavatmal, Maharashtra, India, from December 2019 to December 2021. A sample size of 150 patients was taken for study. The predisposing factors, clinical features with which the patients presented were studied clinically. Otoscopic examination was done and type of fungal colony identified. The ear swab from affected ear or ears are taken and sent for fungal culture. Thorough aural toileting done and maximum debri was removed. The fungal reports were collected and the patients response to treatment was evaluated at the end of four weeks. All the data collected was entered into a master chart in Microsoft Excel 2019 and Statistical Package for the Social Sciences (SPSS) software version 23.0 was used for analysis of study. The p-value obtained is less than 0.05 and the study was hence proved significant. Results: Most (59.9%) of the patient’s age were from 16 to 45 years age group and there were 82 (54.67%) males and 68 (45.33%) females. The most common predisposing factor was unsterile methods of ear cleaning (86.6%) followed by administration of unsterile ear drops (72%). Aspergillus niger was the most common fungal isolate (62%) and clinically most (96.6%) of the cases responded to clotrimazole. Conclusion: Mycotic otitis externa being the most common fungal infection of external ear canal, which can be treated adequately and effectively. The region wise fungal population diversity identification will help in effective treatment. Aural toileting along with topical antifungal agents is found to be effective in majority of the cases.