OBJECTIVE To study the clinical features and the treatment of refractory mycotic otitis media. METHODS From February 2005 to February 2009, 62 cases diagnosed as refractory mycotic otitis media were randomly divided into two groups. One group was 31 cases treated with local daubing Miconazole Nitrate Cream and another group was 31 cases treated with oral Itraconazole. The clinical features and fungi of distribution were retrospectively analyzed. RESULTSAspergillus was the most common fungi(70.6%). After two weeks treatment, 29 cases were cured in the group of Itraconazole, while 21 cases were cured in the group of Miconazole Nitrate Cream. CONCLUSIONRefractory mycotic otitis media is deep-seated mycotic infection and the primary pathomycete was aspergillus. The curative effect with oral Itraconazole was significantly better than that with local daubing Miconazole Nitrate Cream.