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What is fungal otitis media?
Fungal otitis media – this is one of the varieties of inflammation of the ear, characterized by the fact that certain parts of it are affected by mold yeast-like fungi. Most often, the walls of the external ear canal, the skin lining the auricle, the tympanic membrane and the middle ear cavity are included in the pathological process. In medicine, fungal otitis is called otomycosis.
According to statistics, the disease is quite common. Among the total mass of otitis, the diagnosis of “otomycosis” is made in 18,6% of cases in adults and in 26,3% in children. About 10% of the world’s population suffer from this pathology.
Symptoms of fungal otitis
There are a number of symptoms that characterize the development of fungal otitis media:
Persistent or intermittent itching in the ear.
Headache. Sometimes they are accompanied by dizziness.
The appearance of sulfur plugs.
Irritation and increased sensitivity of the auricle.
Hearing loss, feeling of fullness in the ears. This symptom is especially pronounced in mycotic otitis media.
The appearance of characteristic secretions. With otomycosis, they may have a gray, brown or yellowish tint. Their number is determined by the stage of the disease and the fungus that caused the ear damage. The discharge has no smell, which makes it possible to identify them from purulent exudate.
If the disease is localized in the outer ear, then crusts and plugs form in it, liquid discharge appears. There may be itching behind the ear. Hearing is not greatly reduced.
During the acute phase, some patients experience an increase in body temperature.
Swelling of the ear mucosa.
Causes of fungal otitis media
The cause of the development of fungal otitis is infection with fungi of a certain kind. There are many of them, but most often mold fungi lead to the disease, although cases of infection with their yeast-like relatives are not uncommon. They begin to spread and show pathogenic activity when certain conditions exist for this.
These factors include:
Taking medications, namely a long-term course of antibiotic therapy.
High humidity.
Prolonged and uncontrolled use of immunosuppressants.
Purulent otitis media preceding fungal otitis.
Injury to the mucous membrane of the ear. It is those people who pay special attention to the hygiene of the ear canal and use cotton swabs for this purpose, more often than others suffer from fungal otitis media.
Foreign body in the ear
Diabetes
Allergy
Itchy dermatitis, eczema
Types of fungal otitis media
There are several types of fungal otitis media. Depending on where the pathological process is localized, otolaryngologists differentiate:
The external form of the disease, when only the auricle and external auditory canal are affected. This is the most common form of fungal otitis media.
Fungal maringitis. When the eardrum is inflamed. This form of the disease is extremely rare, in about 1% of cases.
Fungal otitis media affects the middle ear cavity.
Postoperative otomycosis of the middle ear. This type of pathology is characterized by the fact that it develops in the middle ear cavity after surgery.
Diagnosis of fungal otitis media
In order to establish the presence of a fungal infection of the ear, doctors most often resort to cultural and microscopic examination. This requires the collection of discharged contents from the ear. It is important to carry out the sampling correctly, since an insufficient amount of material or taking it from the wrong place leads to the fact that fungi may not be detected.
In order to determine external fungal otitis, the doctor will need a visual examination, in which he will reveal infiltration and redness of the skin, as well as the presence of pathological secretions.
Otomycosis of the middle ear will be established by otoscopy, during which perforation of the tympanic membrane and the presence of corresponding secretions will be detected.
When a patient has fungal myringitis, the otolaryngologist will see an edematous and red tympanic membrane, mycelium is found on its surface, there is no light reflex.
Treatment of fungal otitis media
Treatment of fungal otitis is reduced to the use of various forms of antimycotic agents. First you need to wash the ear with antifungal agents. For this, Amphotericin, Burov’s liquid, Chinozol, Nystatin, Clotrimazole and other medicinal solutions are used. Before washing, it is important to carry out an ear toilet, which should be aimed at removing the epidermis, sulfur and mycelium of fungi.
In addition to treatment with antifungal drugs, it is important to establish the cause that caused otomycosis and get rid of it. To do this, it is necessary to increase the human immunity, if possible, refuse to take antibiotics, and normalize the microflora of the ear. It is important to completely cure concomitant diseases that affect the state of the immune system.
It often happens that otomycosis is caused by a mixed microflora, therefore, in addition to antifungal drugs, antibacterial agents are prescribed. If necessary, therapy is supplemented by taking antihistamines and painkillers.
In most cases, it is possible to get rid of the disease, although this process is quite complicated and lengthy. Basically, the success of treatment depends on the completeness of the elimination of the provoking factor and the competent selection of an antifungal drug.
Sometimes, against the background of otomycosis of the middle ear, adhesive otitis media develops. It is characterized by the formation of adhesions and hearing loss, which is irreversible. That is why it is so important to seek treatment on time. Another rare but formidable complication of untreated otomycosis is fungal sepsis and the spread of mycosis to the internal organs. As for the recurrence of the disease, it is more often observed with postoperative mycosis of the middle ear.
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