Department of otorhinolaryngology, IMS and SUM hospital, Siksha "O" Anusandhan university, K8, Kalinganagar, 751003 Bhubaneswar, Odisha, India.
Department of community medicine, IMS and SUM hospital, Siksha "O" Anusandhan university, K8, Kalinganagar, 751003 Bhubaneswar, Odisha, India.
J Mycol Med. 2018 Mar;28(1):122-127. doi: 10.1016/j.mycmed.2017.11.006. Epub 2017 Dec 7.
Otomycosis is a common clinical condition seen in outpatient department of otorhinolaryngology. The treatment of the otomycosis is also very simple. However, sometime it is difficult to treat otomycosis along with mastoid cavity, chronic suppurative otitis media, immunocompromised patient, etc. with conventional treatment, called recalcitrant otomycosis. Here, we describe a technique of treatment for recalcitrant otomycosis.
This is a prospective observational study/clinical trial carried out on 44 patients of recalcitrant otomycosis. They are divided into two groups, each of 22. One group treated with routine clotrimazole topical eardrops whereas other group treated with povidone iodine soaked gelfoam, placed in the external auditory canal.
There was no significance difference according to the age (P=0.134), gender (P=0.760) and causative agents (P=0.750) between treatment groups. The resolution of the symptoms showed statistically significant on itching (P=0.0001), otorrhoea (P=0.0033), fullness (P=0.0432) and earache (P=0.0259), whereas no statistical significant on hearing loss (P=0.0683), when treating with povidone iodine soaked gelfoam as compared to routine (clotrimazole) treatment. Resolution of signs like canal wall erythema (P=0.0045), tragal tenderness (P=0.0012) and congestion of tympanic membrane (P=0.0088) is statistically significant when comparing clotrimazole with povidone iodine. Apart from these, we did not reveal any adverse effects from the study populations treated with povidone iodine soaked gelfoam.
Use of the povidone iodine soaked gelfoam at the external auditory canal in recalcitrant otomycosis is an effective and well-tolerated treatment.
耳真菌病是耳鼻喉科门诊常见的临床病症。耳真菌病的治疗也非常简单。然而，在常规治疗下，有时治疗伴有乳突腔、慢性化脓性中耳炎、免疫功能低下等的耳真菌病会很困难，这种情况下称为难治性耳真菌病。在此，我们描述了一种难治性耳真菌病的治疗方法。
这是一项针对 44 例难治性耳真菌病患者的前瞻性观察研究/临床试验。他们分为两组，每组 22 例。一组用常规克霉唑滴耳液治疗，另一组用聚维酮碘浸泡的明胶海绵置于外耳道。
根据年龄（P=0.134）、性别（P=0.760）和病原体（P=0.750），两组之间没有显著差异。治疗后，瘙痒（P=0.0001）、耳漏（P=0.0033）、耳闷（P=0.0432）和耳痛（P=0.0259）等症状的缓解具有统计学意义，而听力损失（P=0.0683）无统计学意义，与常规（克霉唑）治疗相比，用聚维酮碘浸泡的明胶海绵治疗时。与克霉唑相比，比较时，耳道口壁红斑（P=0.0045）、舟状窝压痛（P=0.0012）和鼓膜充血（P=0.0088）等体征的缓解具有统计学意义。此外，我们未发现用聚维酮碘浸泡的明胶海绵治疗的研究人群有任何不良反应。
在外耳道中使用聚维酮碘浸泡的明胶海绵治疗难治性耳真菌病是一种有效且耐受良好的治疗方法。
