JOURNAL READING

A CLINICAL STUDY
OF OTOMYCOSIS
Conselours :
Dr. Tris Sudyartono, Sp.THTKL
Dr. Agus Sudarwi, Sp.THT-KL
Dr. Santo Pranowo,
Present:Sp.THT-KL

Jose Timothy 11
2012 262
Paskalina 11 2013
248

INTRODUCTION
Otomycosis fungal
infection of the EAC ; middle
ear.
Fungi 10% of OE ;
opportunistic infections,
>> immunocompromised
individuals
Prevalence hot humid and
dusty areas of tropic and
subtropics (as fungi are
abundant in soil or sand that
contains decomposing
vegetable matterairborne)

 Andrall and Gaverett the 1st to describe fungal

infection on the ear (Aspergillus and Candida are the
most common species encountered)
In EAC, fungal mass doesnt not protrude, even in
the most chronic cases. It usually growing in the
inner one-third of the EAC.
Otomycosis presents with nonspecific symptoms
pruritus, discomfort and pain in the ear, aural
fullness, tinnitus, hearing impairment, sometimes
discharges, and recurrence is common.

 Presidisposing factors for

otomycosis :
Habitual instrumentation
Unhygienic habits
Immunocompromised individuals
Pre existing ear disease
Extensive use of antibiotics
eardrops, and chemotherapeutic
agents

 Otomycosis recurrence to the treatment

determine whether its an isolated entity
or related to any systemic disorder or the
result of an uderlying immunodeficiency
disorder
Diganosis : clinical manifestation and
microbiological confirmation (microscopy
and culture)
Main treatment involves removal of debris
(toileting of the external ears) and the use
of antimycotic agents such as
clotrimazole. Also keeping the ear dry

Material and Methods

A prospective study was conducted on 200 patients
clinically diagnosed with otomycosis at Outpatient Clinic
at Sri Venkateswara ENT institute, Vicotria Hospital and
Bowring and Lady Curzon Hospital attached to Bangalore
Medical college and Research Institute
Period from October 2010 to September 2012
Inclusion Criteria : the study included patients of all
patients of all age group and either sex with a clinical
diagnosis of otomycosis
Exclusion criteria : only new cases of otomycosis will
be included. The patients who were already on treatment
for otomycosis were excluded from the study

 200 cases were subjected to a

comprehensive history and
clinical and laboratory
investigation

The outer part of pateints EAC

was cleaned using sterile swabs
and the material from the
deeper portion of the EAC was
taken using sterile aural swabs
sent to microbiology
processing (microscopic
examination with KOH10% and
inoculated over Saborauds
dextrose agar media for culture)

GRAPH 1 : AGE-WISE
DISTRIBUTION OF STUDY
POPULATION

GRAPH-2 : SEX-WISE DISTRIBUTION

IN STUDY POPULATION

GRAPH-3 : SYMPTOMS AMONG

STUDY POPULATION
20% patients had all the
symptoms.
Clinical examination
canal skin erythema and
fungus debris in all cases.
Six of the
immunocompromised
patients had a small
central perforation of the
tympanic membrane
behind the handle of
malleus. They had not
previously experienced
ear pain or otitis media.

GRAPH-4 : PREDISPOSING FACTORS FOR

OTOMYCOSIS IN STUDY POPULATION

GRAPH-5 : ASSOCIATED MEDICAL

HISTORY IN STUDY POPULATION

GRAPH-6 : LATERALITY
DISTRIBUTION IN STUDY
POPULATION

GRAPH-7: VARIOUS FUNGAL ISOLATES IN THE

IMMUNOCOMPETENT GROUP AND
IMMUNOCOMPROMISED GROUP IN STUDY
POPULATION

IMMUNOCOMPROMISED GROUP

IMMUNOCOMPETENT GROUP

GRAPH-8 : TREATMENT OUTCOME

Topical

No.

1st follow 2nd follow 3rd follow 4th follow

Antifungal

of

up

up

up

up

Clotrimazole

cases
180

Good

Good

Good

NAD

response

response

response

No

Good

Good

response

response

response

Fluconazol
e

20

NAD