Abstract:

Objective To explore possible etiology, diagnosis method, and different treatment plans of chronic suppurative otitis media with fungus infection. Methods Sixty-five cases of chronic suppurative otitis media with fungus infection were retrospectively analyzed. According to the symptoms, otoscopic examination, and diagnosis of fungal identification results, the patients received medicine (local anti-fungus drugs, oral anti-fungus drugs, or local and oral anti-fungus drugs) and ear operation following efficacy evaluation. Results After fungi identification, all patients were treated by anti-fungus drugs as diagnostic therapy. For local medicine, dry ear rates of using glycerin otic nystatin, terbinafine hydrochloride cream, and kenacomb cream or triamcinolone cream were 66.67%, 81.82% and 90.00%, respectively. In oral medicine, dry ear rates of using terbinafine hydrochloride and Sporanox were 77.78% and 76.92%. In local and oral medicine, dry ear rate was 90.91%. Nine patients undergone operation were all cured. The total cure rate was 13.85%; dry ear rate, 81.54%; and inefficiency rate, 4.61%. Conclusion There was no definitive relationship between fungal infection of the middle ear and immunocompromise or long-term using antibiotics. Local factors might play important roles, such as moisture in the ear canal and mastoid cavity. Pus culture and smear examination may play definitive roles in diagnosis. For patients with chronic suppurative otitis media, prompt tympanoplasty should be advised after fungal infection controlled.

Key words: otitis media, fungus infection, diagnostic treatment