3.4 External auditory canal mycosis
3 patients suffered from the external auditory canal mycosis after ITD therapy. All the 3 patients were in the ITD2 group (5mg/ml), while no patients in ITD1 group (2mg/ml ) suffered from the external auditory canal mycosis which suggested that the occurrence of external auditory canal mycosis might be positively related to the dose of dexamethasone.
One patient experienced the mycosis 12 days after the beginning of ITI. He developed a thick white fungus silk on the left tympanic membrane. We injected triamcinolone acetonide cream into the external auditory canal to eliminate the fungal for 2 week. After treatment, the fungus silk fade away. Then we retreated the patient with ITD therapy. (figure 2a)
The second patient experienced the fungus in the external canal after 21 days with ITI therapy. At first, there was a lot white, brown, yellow fungus folk in the right external canal, 7 days later, he developed right otitis. He was treated with antibiotics, and applied triamcinolone acetonide cream to the external canal. 14 days later, the infection was controlled, but he experienced a perforation of the eardrum after 3 months. He kept on the triamcinolone acetonide cream therapy weekly for 2 weeks, the fungi disappeared but a persistent perforation was remained. (figure 2b)
The third patient suffered from the external auditory canal mycosis at the 18 days after the beginning of ITD. During that time, she received2 times injection in the 7 days when she was treated in the inpatient department. And at the 18 days, she felt obvious itching and a deeply block up in the right ear, and some green secretions came out of the auditory canal. under the endotoscope, we found the mycoses was so thick that covered all the membrane and those secretion appeared white, brown and black in color. There was a needle-like perforation in the anterior-inferior quadrant of membrane after we clean up the secretion and the membrane atrophy thinning was found around the perforation. Then we treated the patient with triamcinolone acetonide cream in the canal for 3 weeks. After treatment, the mycosis disappeared and the perforation was healed. (figure 2c and 2d)