BACKGROUND: Because of recent concern about occurrence of otomycosis in otolaryngologic practice, we studied them. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of otomycosis. METHOD: We evaluated the clinical and mycological aspects of otomycosis in 38 patients from March 1996 to February 1998 in Dongguk University Hospital. RESULTS AND CONCLUSION: Otomycosis showed high incidence in the twenties (23.7%). The ratio of male to female patient was 1:1.5. The seasonal prevalence was highest in autumn. Most common symptoms were otorrhea (39.4%) followed by itching, obstruction sensation, otalgia, and hearing disturbance. The common causative organisms of otomycosis were Aspergillus(A.) niger (36.8%) followed by A. terreus (26.3%), A. flavus (21.1%), A. fumigatus (7.9%), Candida albicans (5.3%), and Mucor sp. (2.6%).
Candida albicans ; Earache ; Female ; Hearing ; Humans ; Incidence ; Male ; Mucor ; Niger ; Otomycosis* ; Prevalence ; Pruritus ; Seasons ; Sensation

OBJECTIVE: To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symptoms, endoscopic findings, and fungus culture of the ear discharge. METHOD: Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one antifungal medication regimens (compound resorcinol solution) in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up. RESULT: Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy. CONCLUSION Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.
Antifungal Agents ; therapeutic use ; Debridement ; Fungi ; Glycerol ; Humans ; Otitis Externa ; diagnosis ; microbiology ; Otomycosis ; diagnosis ; Outpatients

Ear Canal ; drug effects ; Econazole ; therapeutic use ; Endoscopy ; Humans ; Otomycosis ; drug therapy ; Triamcinolone Acetonide ; therapeutic use

BACKGROUND AND OBJECTIVES: To determine the efficacy of filling the external auditory meatus with 1% clotrimazole at a single visit for the treatment of otomycosis. SUBJECTS AND METHODS: This prospective study included 40 patients who were referred to our clinic with complaints of ear itching, pain, and fullness, and were diagnosed with unilateral otomycosis. After cleaning the mycotic hyphae from the external auditory meatus, the ear canal was filled with 1% clotrimazole, using an intravenous catheter and syringe. The patients received follow-up examinations on post-treatment days 7, 15, and 45. RESULTS: The follow-up otomicroscopic examinations revealed that 95% of the ear canals were entirely clean and that all symptoms had resolved. The post-treatment scores of pain, aural fullness and itching were significantly lower than the pre-treatment scores (p < 0.01). CONCLUSIONS: Filling the external auditory meatus with 1% clotrimazole at a single visit is an easy, efficient, and cost-effective treatment for otomycosis. Additionally, high patient compliance makes this treatment superior to long-term topical therapy.
Catheters ; Clotrimazole ; Ear ; Ear Canal ; Follow-Up Studies ; Humans ; Hyphae ; Otomycosis ; Patient Compliance ; Prospective Studies ; Pruritus ; Syringes

BACKGROUND: Otomycosis is a mycotic disease of the external auditory meatus. Aspergillus is the most common pathogen. Despite the fact that a great number of fungi are considered as the cause of otomycosis, otomycosis due to dermatophytes occurs with great rarity. OBJECTIVE: The purpose of this study was to investigate clinical and mycological features of dermatophytosis in the external auditory meatus. METHODS: We performed a clinical and mycologic analysis of 17 patients who had been clinically and mycologically diagnosed with dermatophytosis of the external auditory meatus. In addition, amplication of TRS-1 and TRS-2 of the ribosomal DNA nontranscribed spacer was performed on strains of Trichophyton (T.) rubrum and T. raubitshcekii which were isolated from skin lesions of the external ear and cerumen in 6 patients. RESULTS: The ratio of male to female patients was 1.4:1. The age of patients were 6 to 72 and mean age of onset is 36.4. Eleven patients had concomitant dermatophytosis of other sites. Tinea unguium was combined in 7 cases, tinea pedis in 4 cases, tinea corporis in 3 cases, tinea manus in 2 cases and tinea cruris in 1 case. The positive rate of KOH examination was 88.2% and the positive rate of fungal culture on PDAC media was 88.2%. The most common organism cultured was T. rubrum (80.0%), followed by T. raubitschekii (13.3%) and T. mentagrophytes (7.7%). Ten patients were treated with topical terbinafine and seven patients with oral itraconazole, so all patients were cleared of fungi from the external auditory meatus and inflammation was resolved. With TRS-1 and TRS-2 amplication, 4 of 5 pairs of T. rubrum and 3 strains of T. raubitshcekii showed the same types regardless of the site in each patient. CONCLUSION: Dermatophytosis occurs rarely in the external auditory meatus but we experienced 17 cases of dermatophytosis at this site. With suspected otomycosis, dermatophytosis of the external auditory meatus and concomitant dermatophytosis must be investigated and treated simultaneously to prevent any recurrence.
Age of Onset ; Arthrodermataceae ; Aspergillus ; Cerumen ; DNA, Ribosomal ; Ear, External ; Female ; Fungi ; Humans ; Inflammation ; Itraconazole ; Male ; Onychomycosis ; Otomycosis ; Recurrence ; Skin ; Tinea Pedis ; Tinea* ; Trichophyton

As increasing numbers of antibiotics, adrenocorticosteroids, and antitumor agents have come into use, so increasing numbars of mycotic diseases have been identified. Qtomycosis, a mycotic infection of the extcrnal ear which is occasionally accompanied by dermatitis of the surrounding skin, is corsidered to be such a disease. While opinion vari.es as to whether otomycosis is caused by a saprophytic or a pathogenic organism, our clinical obs:rvations revealed pathological inflammation of the external auditory canal with profuse fungal elements. During August 1975, l3 specimens of ear wax were taken from patients whv visited the out-patient ENT clinic of this hospital. All patients had had their ears clea,ned at a barber shop prior to visiting the ENT clinic. Because ar cleaning instrumenta (scoops and brushes) are re-used m Korean Sarber shops, 204 of theae in- strum.ent;s were randomly selected from different barber shops and examined. KGH mounts and Lactophenol cot@ten blue stains were used to examine the specimens. Qf the lR ear wax specimens, I2 samples (92. 3%) reveaIed Aspergillus sp. and 1 sample (7. 7%) revealed Penicillium sp. Of the 204 ear cleaning instrumenta tested, l94 colonies grew in culture. Of these cultures, 146 (75. 3 %) were Aspergillus sp., 9 (4. 6%) were Mycelia sterila, 5 (2. 6%) were Fenicillium sp., 4 (2. 1 %) wr Al- terna,ria, 2 (l. 0%) were Stemphylium sp., 1 (0. 5%) was Geotrichum sp., and 27 (13. 9%) were of an unknown species. Of the 146 Aspergillius sp. cultures, 99 (67. 8%) were Asp. terreus, 17 (11.6%) were Asp. glaucus, 5 (3.4%) were Asp. niger, 17 (11. 6%) were Asp. flavus-oryzRC, R (2. 1 %) Were Asp. versicolor, and 5 (3. 4 %) were athers. Beca.use of the close correlation between the fungi cultivated from ear wax apc imens and those cultured from ea,r cleaning instruments, the authors believe that the ear cleaning instruments used in the barber shops could well have been the primary source of infection. In this study the authors also discuss the probable causative factbrs of otomycosis arrd a review of the literature is presented.
Anti-Bacterial Agents ; Antineoplastic Agents ; Aspergillus ; Cerumen ; Coloring Agents ; Dermatitis ; Ear ; Ear Canal ; Epidemiologic Studies* ; Fungi ; Geotrichum ; Humans ; Inflammation ; Niger ; Otomycosis* ; Outpatients ; Penicillium ; Skin ; Viperidae

Fungi have been recognized as a significant cause of external otitis and it may be the primary pathogen or be part of a mixed infection. In the immunocompromised host, fungus is capable of producing infection in inner ear or middle ear. Otomycoses are most frequently caused by Aspergillus spp. and Candida sap. There are few reports that Aspergillus species other than A. fumigatus, A. niger and f. flavus have caused chronic otitis media. We report two cases of chronic otitis media caused by Aspergillus ferrous in Korea. One case is a 7-year-old girl who had recurrent serous otorrhea and otalgia for 4 years, was reattended otolaryngology clinics with otorrhea of 3 days durations and another is a 6-year-old girl who had serous otorrhea for 2 months and 3 day fever, was attended otolaryngology clinics with them. Microscopic appearance and colony morphology from ear discharge cultures revealed A. ferrous. The infection responded well to topical ketoconazole therapy. This report should help to raise medical personnel's awareness of such human opportunistic fungal ear infections.
Aspergillus* ; Candida ; Child ; Coinfection ; Ear ; Ear, Inner ; Ear, Middle ; Earache ; Female ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Ketoconazole ; Korea ; Niger ; Otitis Externa ; Otitis Media* ; Otitis* ; Otolaryngology ; Otomycosis

Fungal infections in the ear of immunocompetent patients are mainly observed as otomycosis within the external auditory canal. Benign fungal colonization (fungal ball), though they are common in the paranasal sinuses, has never been reported in the middle ear cavity of a healthy population. We present a case of fungal ball in the middle ear of a 30-year-old, immunocompetent male. He did not have any illness except chronic suppurative otitis media in the right ear. On physical examination, only small central perforation was seen in the right tympanic membrane. Temporal bone computed tomography did not reveal any abnormal finding except thickened tympanic membrane. Intraoperative examination demonstrated a dark gray, cheese-like material in the mesotympanum. After tympanoplasty, mycological staining and histopathologic examination identified the surgical sample to be Aspergillus. So we reported, with a review of literature, the first case of Aspergilloma occurring in the middle ear of a healthy patient.
Adult ; Aspergillus* ; Colon ; Ear ; Ear Canal ; Ear, Middle ; Humans ; Male ; Otitis Media* ; Otitis Media, Suppurative ; Otitis* ; Otomycosis ; Paranasal Sinuses ; Physical Examination ; Temporal Bone ; Tympanic Membrane ; Tympanoplasty

BACKGROUND AND OBJECTIVES: Locacorten Vioform (Novartis UK) is frequently prescribed for otomycosis. Its component, Clioquinol, also has anti-bacterial properties. Up to this point, its ototoxic potential has not been evaluated. Our objective aims to evaluate Locacorten Vioform’s potential ototoxicity when applied directly to the middle ear cavity. MATERIALS AND METHODS: We performed an experimental prospective animal study in our animal research center with 20 Hartley guinea pigs divided into 2 groups. The first group (experimental) was treated with Locacorten Vioform in one ear and with a physiologic saline solution in the other. The second group (positive control) was treated with concentrated gentamycin in one ear and physiologic saline in the other. Auditory brainstem response measurements were obtained before and after three sets of injections. Statistics were analyzed using a variance analysis with repeated measures. The histological state of cochlear outer hair cells was compared between the two groups using scanning electron microscopy. RESULTS: Average hearing loss in ears treated with Locacorten Vioform was 32.1 dB, compared with a 2.5 dB average loss in the saline-treated ears. Ears treated with gentamycin lost an average of 33.0 dB. There were clinically and statistically significant differences between the two ears of the guinea pigs in both groups (p < 0.001). Scanning electron microscopy revealed severe pericochlear and cochlear inflammation and ossification in the Locacorten Vioform-treated ears. Gentamycin caused significant destruction of outer hair cell architecture. CONCLUSIONS: Locacorten Vioform induces a hearing loss similar to that caused by gentamycin when applied directly to the middle ear of a guinea pig model. Electron microscopy indicates a pericochlear and cochlear inflammatory reaction with ossification.
Animal Experimentation ; Animals ; Clioquinol ; Ear ; Ear, Middle ; Evoked Potentials, Auditory, Brain Stem ; Gentamicins ; Guinea Pigs ; Guinea ; Hair ; Hair Cells, Auditory, Inner ; Hair Cells, Auditory, Outer ; Hearing Loss ; Inflammation ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Otomycosis ; Prospective Studies ; Sodium Chloride