Question
I have a client who has worn an ITE for many years. He recently obtained a new one and shortly after developed a fungal infection in his ear which he attributes to the device. What are the common causes of fungal infection in the ear and how does a hearing aid cause it or contribute to the problem?
Answer
Hearing aids do not cause otomicosis. This is a fungal infection of the external auditory canal, which generally occurs as a result of trauma to the skin lining of the ear canal. This trauma can be self-induced from a finger nail, bobby pin, car key, etc., or can be due to external penetrating trauma to the ear. It is possible that the hearing aid mold caused irritation or a tear in the skin lining of the external auditory canal, which allowed the normal fungal inhabitants of the ear canal to cause an infection. The ear canal is normally a happy host to a variety of bacteria and fungi, but a torn ear canal skin lining in combination with moisture is a welcome medium for fungal and/or bacterial infection. This is easily treated with non-use of the hearing aid and appropriate otic drops (Domboro). The only patient population more prone to such infections would be diabetics and those who are otherwise immuno compromised.
BIO: Dr. John P. Leonetti is Professor of Otolaryngology-Head and Neck Surgery at Loyola University Medical Center, where he has been director of otology and skull base surgery since 1988. He can be reached on-line at jleonet@lumc.edu.
John P. Leonetti, MD
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