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)