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Q. Will otomycosis spread to my middle ear through the hole in my eardrum?

Answered by
Dr. Sandeep Shrestha
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 11, 2020 and last reviewed on: Mar 08, 2021

Hi doctor,

Currently, I have otomycosis in my right ear and it perforated my eardrum before 10 days. Currently, I have symptoms of conductive hearing loss, tinnitus, and ear pain. It seems to be improving and it is sporadic now. I do not have any drainage from my middle ear with strange popping noises. I had sporadic discomfort in the bone behind my ear and it was not so severe. I took three antibiotics such as Amoxicillin, Cefuroxime, and Clarithromycin before having this diagnosis and Ciprodex ear drops for the presumed bacterial ear infection.

Before having a TM perforation, I had Locacorten antifungal drops for the white or black fungal growth for three days. I stopped it due to perforation. I thought that I have otomycosis when my doctor told me that I have something black on my TM. I thought it was dried blood and the doctor gave me Cefuroxime. I have done four suction debridement of fungal debris against my eardrum and I treated it with Clotrimazole 1% cream daily for ten days. After that, my TM got inflamed and the hole was not seen clearly as it was small and the ear canal got improved due to the application of cream according to the last debridement.

After that, the ENT doctor prescribed me Amoxiclav for seven days. Is it good to take oral antifungal medication along with antifungal cream for TM perforation? Will the fungus spread to my middle ear through the hole? Does my sporadic or nonsevere discomfort in the bone behind the ear indicate that the infection is spreading? Will my hearing return back to normal?

#

Hi,

Welcome to icliniq.com.

As per the concern, you do not need to take oral antifungals as it is improving. You can use Candibiotic ear drops (Lidocaine, Beclomethasone, Clotrimazole and Chloramphenicol) as they will be more effective in treating otomycosis and congestion of the tympanic membrane. There is a rare chance to have spread of otomycosis in the middle and inner ear. But you do not need to be worried. It can be the symptoms alone but you have to be careful while having tenderness over the mastoid area. If the perforation is small without infections, then it heals on itself and your hearing will become normal.


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