Background
Otitis externa due to fungal pathogens more commonly presents in diabetic and immunocompromised patients. The symptoms are similar to those with other causes of otitis externa; pruritis, ottorhoea, otalgia and reduced hearing from oedema and/or accumulation of debris1-4. Fungal pathogens are the cause of 10% of otitis externa and lead to a loss of the protective lipid/acid balance of ear. The predominant causative pathogens are Candida and Aspergillus species2,3,5 colonising the squamous epithelium of the external auditory canal. The mainstay of treatment is a combination of microsuctioning, debridement and topical antifungal treatment.3,6
This paper aims to summarise the management of tympanic membrane perforations secondary to fungal otitis externa, an infrequently reported consequence of suboptimal management of this condition.