▲The doctor is treating the case. (Photo provided by Chen Denglang)
Text / Chen Denglang
▲The patient’s right external auditory canal is covered with a ring of earwax covered with white hyphae (left image); after removal of the earwax, the eczematous external auditory canal is exposed (right image). (Photo provided by Chen Denglang)
A 54-year-old middle-aged woman’s right ear canal is always itchy. When listening to sounds, she feels “blunt”, as if there is a wall. I thought it was caused by the swelling of earwax after bathing. I often used metal ear picks or cotton swabs to dig my ears, but only some white crumbs were digged out, with a strange sour smell, and the more I dig, the more itchy.
In the past month, I have started to hear a continuous “ummm” sound in my right ear, which is more pronounced in the dead of night.
Please read on…
Originally thought it was hearing aging, I went to a hearing aid company in the market for hearing screening and found that I have conductive hearing impairment in the right ear. When I went to the doctor, I found that her right external ear canal was covered with a circle of lumpy material. After removing it, it was determined that it was not cotton wool, but earwax covered with white hyphae, which was completely different from the yellow koji hyphae commonly seen in otomycosis. Different, it turned out to be suffering from a very rare ear white mold disease (oto-mucomycosis).
In addition, she was found to have severe allergic rhinitis with pale inferior turbinates on both sides and a lot of nasal discharge.
White mold originally exists in the soil, rot and air, and rarely infects the human body. However, due to allergic reactions in the epithelium of the external auditory canal, the earwax glands also secrete an alkaline liquid when secreting earwax, which is quite suitable for mold growth. White mold spores in the air fall on it, and mycelium will grow quickly.
In order to resist infection, the skin secretes a large amount of sebum and morbid earwax, which mix together and block the external auditory canal, resulting in conductive hearing impairment, resulting in compensatory tinnitus, and it will become a breeding ground for mold growth, forming a vicious circle.
To treat this disease, it is necessary to remove all the earwax grown by mold, expose the underlying skin, apply anti-fungal ointment, and then continue to use boric acid ear drops for at least 1 month to keep the external auditory canal weakly acidic and prevent the growth of residual molds. can be cured.
In order to prevent patients from digging out their ears due to itchy ears, it is necessary to continue taking antihistamines, treat allergies, and relieve itching, so as not to destroy the newly grown sebum layer and healthy earwax in the ear canal.
Untreated temporal bone infection can be fatal
It should be noted that if white mold disease is not treated immediately, especially those with poor immune function or poor blood sugar control, it will continue to spread rapidly, invading the hard bone and cartilage of the ear canal downward, and invading the eardrum, middle ear and inner ear inward. , the entire temporal bone becomes infected and can be fatal. If you have itchy ears or tinnitus, you should seek medical attention first, and don’t blindly dig your ears and ignore them.
(The author is a physician at Jifeng Otolaryngology Clinic)
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