{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:59:26Z","timestamp":1753869566348,"version":"3.41.2"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023331","name":"LEO Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To study the predisposing factors, treatment, and complications of <jats:italic>Aspergillus<\/jats:italic> otitis externa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of patients diagnosed with <jats:italic>Aspergillus<\/jats:italic> otitis externa at the Department of Otorhinolaryngology, Helsinki University Hospital, between January 2010 and December 2018 was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 269 <jats:italic>Aspergillus<\/jats:italic> otitis externa (OE) patients, 96 developed otitis media (OM) and 7 developed mastoiditis. Antibiotic and steroid treatment and otological history were risk factors for <jats:italic>Aspergillus<\/jats:italic> OE. Systemic diseases and immunocompromising states were more common in mastoiditis patients. Repetitive ear cleaning and topical drugs are primary treatments, but systemic drugs and surgery were needed in resistant and invasive cases. Forty\u2010five novel tympanic membrane (TM) perforations were reported. A strong association between <jats:italic>Aspergillus<\/jats:italic> species and final infection types was found; <jats:italic>A. niger<\/jats:italic> was the dominant species in OM and in novel TM perforations, whereas <jats:italic>A. flavus<\/jats:italic> and <jats:italic>A. fumigatus<\/jats:italic> caused mastoiditis. Some of the TM perforations persisted despite treatment. Permanent hearing impairment was associated with OM and mastoiditis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As <jats:italic>Aspergillus<\/jats:italic> OE has the potential to cause acute and chronic complications, fungal OE should be suspected early on if the infection persists after conventional treatment. The identification of <jats:italic>Aspergillus<\/jats:italic> species could aid in spotting patients at risk for more severe disease and complications. Intensive local treatment is sufficient in most cases of OE and OM but effective topical antifungals are limited. Patients with <jats:italic>Aspergillus<\/jats:italic> OM and mastoiditis should be followed up for hearing impairment and permanent TM perforations after the infection resolves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level 4 (The Oxford 2011 Levels of Evidence).<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.70028","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T10:40:31Z","timestamp":1729852831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<i>Aspergillus<\/i> otitis externa: A retrospective study of predisposing factors, treatment, and complications"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1963-8111","authenticated-orcid":false,"given":"Milla","family":"Viljanen","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-1721","authenticated-orcid":false,"given":"Riitta","family":"Saarinen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4968-4357","authenticated-orcid":false,"given":"Lena","family":"Hafr\u00e9n","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131209100308"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3889\/OAMJMS.2019.176"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CMI.2015.12.027"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.14639\/0392\u2010100X\u2010669"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01220\u201008"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJPORL.2005.04.012"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.OTOHNS.2006.07.008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319851499"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/MICROBIOLSPEC.MB\u20100017\u20102015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/014556131409300811"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469\u20100691.12389"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JINF.2011.01.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/S12105\u2010018\u20100918\u20102"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.CLINDERMATOL.2009.12.003"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.BJORL.2018.12.007"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1439\u20100507.2007.01409.X"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3906\/SAG\u20101407\u201017"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1258\/002221503321046621"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70028","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T12:13:38Z","timestamp":1729858418000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70028"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/lio2.70028"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70028","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"type":"print","value":"2378-8038"},{"type":"electronic","value":"2378-8038"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-05-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70028"}}