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Fungal infections of the external ear (Otomycosis- also known as Singapore Ear) are common clinical problem encountered in the ENT practice, especially in hot and humid climatic conditions. The common fungus encountered are Aspergillus-niger and fumigatus and also Candida albicans. The ear canal can be easily infected because it is dark and warm, hence bacteria or fungus may grow there, because of high humidity and moisture. Otomycosis most often occurs when too much water gets in the ear canal such as after swimming or showering in chlorinated water. Dr Paulose FRCS, DLO is a Consultant ENT Plastic & Laser Surgeon with over 38 years of world class experience in Ear, Nose, Throat and Laser Surgery treating patients across the world from UK, US, Middle East to Asia.
External ear infection is characterized by inflammation and swelling of the ear canal, resulting in painful conditions. People of all age groups can be affected with otitis externa, but the occurrence rate is more in adults as compared to children.
Other factors that trigger microbial attacks to the external ear are, narrowing of the ear canal due to abnormal bone growth, humid climate, using hearing aids, and self-cleaning with cotton swabs, fingernails, or other objects.
At times, a single follicle in the passage of ear canal may get inflamed and infected, causing localized external otitis. Itching in and around the inflamed ear canal is another manifested symptom of outer ear infection.
Patients with otitis externa experience discharge of pus and unusual, foul-smelling fluid from the ear. Temporary conductive hearing loss is also manifested in some patients with outer ear infection.
Since the ear and throat are connected, itchiness and scratchy sensation of the throat are manifested as referred symptoms of outer ear infection.
As external ear infection causes constriction of the ear canal, patients tend to open the canal with a slim object, or just scratch the outer covering.
Timely treatment is imperative to minimize the risk of chronic infection, malignant otitis, permanent hearing loss, and similar medical complications. In addition to antimicrobial drugs, other complementary medications are directed for managing outer ear infection symptoms. The eardrum also forms a protective barrier that prevents germs and bacteria from entering the middle ear. A revolutionary surgical technique for treating perforations of the tympanic membrane (eardrum) in children and adults has been developed at the Sainte-Justine University Hospital Centre, an affiliate of the Universite de Montreal, by Dr. Myringoplasty is surgical procedures to repair the tympanic membrane or eardrum when it has been perforated or punctured as the result of infection, trauma or dislodgement of a myringotomy tube (also known as a pressure equalization tube). According to a University of Texas study, Crazy Ants may become the dominant invasive ant species displacing Fire Ants in the near future.
The 21st Century is just beginning but science and technology are moving in blazing speeds. External auditory canal shows edema, and black discharge, at time like wet tissue paper in the ear.

Clean the ear canal by vacuum suction under an operating microscope using normal saline at body temperature.
Avoid swimming, or water getting into the ear until the fungal infection is fully eradicated. Turn your head to each side and pull the earlobe in different directions to help water run out. The notable symptoms of outer ear infection are pain, itchiness, reduced hearing, and fluid discharge from the infected ear. Outer ear infection in children may develop due to frequent use of Q-tips for cleaning the ear canal. Contrary to this, diffused otitis externa is diagnosed when a severe case of infection in the ear canal spreads to the eardrum. These should be strictly avoided, as they further irritate the inflamed ear and exacerbate the condition. Say, for example, ear drops formulated with steroids and aluminum acetate are effectual to reduce swelling and inflammation symptoms caused by infections. The eardrum, also known as the tympanic membrane, is a thin layer of tissue that separates the outer ear from the middle ear. Saliba has designated "HAFGM" (Hyaluronic Acid Fat Graft Myringoplasty), requires only basic materials: a scalpel, forceps, a probe, a small container of hyaluronic acid, a small amount of fat taken from behind the ear and a local anesthetic. Myringoplasty (reconstruction of the eardrum) using the HAFGM technique reduces waiting times, cost of the procedure and time lost by parents and children.
Surgical repair of the perforation will allow the patient to recover his or her hearing and prevent repeated ear infections, particularly after swimming or shower. A hair dryer set on the lowest speed and heat can also help dry ears, but be sure to hold it several inches from your ear. The bacterial pathogens responsible for external ear infection are Staphylococcus and Pseudomonas, while fungal strains capable of infecting ear canal are Aspergillus and Candida. These small implements cause injury to the sensitive skin of an infant's ear, which results in inflammation.
Whatever is the case, external ear infection symptoms worsen when accompanied with compacted earwax. In short, correct diagnosis by a trusted doctor is of utmost importance to proceed for prompt treatment.
Antibiotic and antifungal ear drops are recommended for treating bacterial and fungal infections respectively.
Also, treatment involves taking pain killers to get relief from pain, while curing the infection. These vibrations from the eardrum pass through the small bones (ossicles) inside the middle ear. The new technique, which is as effective as traditional surgery and far less expensive, can be performed in 20 minutes at an outpatient clinic during a routine visit to an ENT specialist. The operation, which is performed through the ear canal, allows the body by itself to rebuild the entire tympanic membrane after about two months on average, allowing patients to recover their hearing completely and preventing recurring cases of ear infection (otitis).

Traditionally, these procedures are performed using what are known as lateral and medial techniques, which require hospitalization for at least one day, and 10 to 15 days off work.
After swimming in common pool, put few drops of acetic acid ear drops or any other antifungal ear drops.
Medically referred to as otitis externa or external otitis, the main affected site is the ear canal, but not the pinna or the visible cartilaginous structure.
What happens is, the contaminated water gets trapped in the ear canal, leading to infection. As the skin of the ear canal is inflamed, infection risk is higher, even without exposure to water. Together, they block the ear canal to varying degrees, thus disturbing normal sound collection and perception. Slight pulling of the tragus and viewing by otoscope are adopted by doctors, as a part of physical examination to confirm otitis externa. In case of widespread infection, oral medications of appropriate dosage will be prescribed for the patient. Coming to the prevention of outer ear infection, wearing ear plugs during swimming and taking a shower, keeping the ear dry, and avoiding self-cleaning objects are simple ways to avoid an infection. The result is a therapeutic treatment that will be much easier for patients and parents, making surgery more readily available and substantially reducing clogged waiting lists.
Because it requires no general anesthetic, operating theatre or hospitalization, the technique makes surgery much more readily available, particularly outside large hospital centres, and at considerably lower cost.
Also, water accumulated in the ear after taking shower is a probable reason for contracting infection. This will be sent to a laboratory for testing to find out whether your ear infection is caused by a bacterial or fungal infection. These are usually prescribed as ear drops but your GP may prescribe tablets if you have widespread infection or you’re at risk of having a severe infection.
You may need to have your ear cleaned and any discharge or wax removed by your doctor or nurse before using ear drops to treat an infection. You may be asked to lie down or tilt you head to the side with your affected ear facing upwards when you use ear drops. Sometimes, it’s advised to keep still for ten minutes after using ear drops or a spray.
Trying to remove ear wax yourself can also cause an ear infection, as you may damage the skin of your ear canal. Ear syringing itself carries a risk of ear infection and isn’t recommended as a treatment if your ear canal has been previously inflamed or damaged.

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