Abstract:Objective To summarize the clinical manifestations,etiological characteristics and treatment outcome of patients with fungal external otitis in Southern China to explore the clinical effect of endoscopic debridement plus triamcinolone acetonide cream local injection in the treatment of fungal external otitis. Methods A total of 256 patients with fungal external otitis from the Southern China region between January 2014 and December 2015 were randomly separated into the injection group(n=152) and drug smearing group(n=104).In injection group,triamcinolone acetonide cream was injected into the external auditory canal after the fungal lesions were cleared under the otoendoscopy,once a week,for 3-4 times.In smearing group,the fungal lesions were cleared under the otoendoscopy,and patients were instructed to apply triamcinolone triazide cream to the external auditory canal, once a day,and revisited once a week for a total of 3-4 times.After 6 months follow-up,the therapeutic effects were evaluated by main symptoms and otoendoscopic results.The secretion of external auditory canal was continuously collected from some patients randomly by non-random method for fungal pathogen culture. Results The main symptoms of 256 patients were ear itching (89.8%),ear blocked(80.9%),pus discharge (69.1%),hearing loss (51.2%),ear pain (42.2%),ear odor (18.0%),and so on.Pathogenic detection of fungi in secretion of ear canal in 96 cases showed that 7 cases were negative,and 89 cases(92.7%) were positive with 75 cases of Aspergillus,8 cases of Candida and 6 cases of positive culture results without identified species.Over 6 months follow-up,141 cases were cured,and 11 cases recurred in injection group;86 cases were cured,and 18 cases were recurred in smearing group.The cure rate in injection group was significant higher than that in smearing group (92.8%% vs 82.7%,χ²=6.235,P=0.013). Conclusions Fungal external otitis is very common in Southern China.In the early stage,there are no special symptoms.Ear itching,ear blocked and pus discharge are the main symptoms.The clinical application of otoendoscopy can significantly improve the early diagnosis rate.Aspergillus species is the most common pathogenic fungus.Clearing the local lesions in the external auditory canal under otoendoscopy and injection the canal with local antifungal cream could improve the therapeutic effect obviously.