Epidemiological characteristics and trends in the diagnosis and treatment of fungal otitis externa in children.

Abstract

Background: The clinical features and diagnostic procedures of fungal otitis externa in children have been changed in recent years. This study aimed to summarize and analyze the epidemiological characteristics and evolving trends in the diagnosis and treatment of pediatric fungal otitis externa over a period of 8 years.

Methods: A retrospective study was conducted on children diagnosed with fungal otitis externa between January 2016 and December 2023. The cohort was assigned into two groups based on visit time: early-visit [2016-2019] and late-visit [2020-2023]. Comparisons were made regarding visit patterns, diagnostic approaches, treatment strategies, and etiological characteristics.

Results: A higher prevalence was noted in male patients (P<0.001). The incidence peaked between July and October, with a significant increase in the third quarter (July-September) compared to other periods (P<0.001). The early-visit group (849 cases) had a significantly greater number of patients than the late-visit group (528 cases, P=0.001), and children in the early-visit group were younger (P<0.001). In the late-visit group, the diagnostic approach shifted from fungal smears to a combination of otoscopy and microbial culture, along with increased use of triamcinolone acetonide and econazole nitrate cream due to their broad-spectrum anti-inflammatory properties.

Conclusions: Fungal otitis externa occurs more frequently in male children, with a seasonal peak during summer. A decline in patient numbers was observed in the late-visit group, and the average age of the affected children was higher. Changes in diagnostic methods have influenced treatment strategies, leading to the increased use of triamcinolone acetonide and econazole nitrate cream.