Otomycosis is a disease caused by the development of various types of mold fungi on the walls of the external auditory canal (sometimes on the eardrum).
The causes of otomycosis can be factors such as previous dermatitis of the external auditory canal, eczematous diseases, chronic suppurative otitis media, microtrauma of the skin of the auditory canal. Antibiotic therapy, which suppresses the normal microflora, both with local and general use, causes dysbacteriosis, against which all microbes insensitive to antibiotics develop, and primarily fungi.
Prolonged topical use of hormonal products also does not often lead to a fungal infection of the external auditory canal. Factors predisposing to the development of otomycosis are general or local allergies, metabolic disorders, carbohydrate metabolism and neurohormonal state, as well as the functions of the sulfur glands, special working conditions, such as a waste collector, a cloakroom attendant, a receiver of old things, etc.
In addition, there are a number of favorable conditions for the vital activity of fungi in the external auditory canal – free access to atmospheric air, which provides the oxygen and carbon dioxide necessary for the nutrition of fungi, the absence of direct exposure to sunlight that prevents the development of fungi, high humidity, favorable temperature conditions, the absence mechanical damage to the mycelium of the fungus, since due to the specific anatomical and physiological structure of the external auditory canal, the fungi are protected from external influences; developing, they form dense plexuses of mycelium, causing inflammation of the skin.
Pain, itching in the ear canal, high sensitivity of the skin of the ear canal and auricle, headache on the side of the affected ear, tinnitus, feeling of fullness and stuffy ™ ear.
When examining the ear, the ear canal is narrowed throughout, its walls are macerated and hyperemic (less than in bacterial otitis media). The discharge of the ear canal in the bulk of cases is moderate, may have a different color (gray-black, black-brown, yellowish or greenish) and depends on the type of fungus that caused the disease; it is usually odorless. The tympanic membrane in most patients is hyperemic, infiltrated, with indistinct identification points.
Sometimes a hole in the tympanic membrane is seen (the result of only a fungal infection without involvement of the middle ear). In rare cases, the pathological process can spread beyond the external auditory canal and even the outer ear (skin of the face, neck). After clinical recovery, relapses of the disease can be observed.
The diagnosis is made on the basis of otoscopy and mycological examination of the detachable external auditory canal. The differential diagnosis will need to be carried out with candidiasis (damage by yeast fungi) and dermatitis of the outer ear of a different etiology.
It is necessary to confirm by microscopic examination of the contents of the external auditory canal, sowing separated on nutrient media.
Treatment is strictly individual, taking into account the general condition of the patient, the specifics of the clinical picture of the disease and the type of fungus. A good effect is obtained by prescribing local antifungal products: grisemin, lutenurin or nystatin emulsion, as well as alcohol solutions of flavofungin, fungifen or chinosol. According to the indications, desensitizing treatment is prescribed.