{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:31:40Z","timestamp":1781137900834,"version":"3.54.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Objectives\/Hypothesis:<\/jats:bold> To perform a systematic review and meta-analysis to compare the efficacy of and complications associated with antifungal drugs and traditional antiseptic medication for the treatment of otomycosis.<\/jats:p><jats:p><jats:bold>Data Sources:<\/jats:bold> The PubMed, EMBASE, GeenMedical, Cochrane Library, CBM, CNKI, VIP and other databases were searched from January 1991 to January 2021.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and non-randomized studies (case-control, cohort, and case series) were included to assess the topical use of antifungal drugs and traditional antiseptic medication in patients with otomycosis. The research subjects were patients who were clinically diagnosed with otomycosis and whose external auditory canal secretions were positive for fungi. Funnel plots were used to detect bias, and the Q test was used to assess heterogeneity. The random-effects model was used for meta-analysis. The <jats:italic>t<\/jats:italic>-test was used to assess significance.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Of the 324 non-duplicate studies screened, 16 studies met the criteria for full-text review, and 7 were included in the meta-analysis. Four studies reported recovery conditions (<jats:italic>P<\/jats:italic> = 0.01). Six common complications after medication use were compared, and there were no significant differences. The authors further conducted subgroup analysis according to complications. The differences in the rates of ear distension (<jats:italic>P<\/jats:italic> = 0.007), earache (<jats:italic>P<\/jats:italic> = 0.03) and tinnitus (<jats:italic>P<\/jats:italic> = 0.003) were statistically significant.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The results of this meta-analysis and literature review showed that antifungal drugs and traditional antiseptic medication were effective in relieving symptoms in patients with otomycosis, and the two treatments were associated with different complications. Otolaryngologists have the option to use one medication or a combination of two drugs on the basis of the condition. Future research in this area should include RCTs with long-term follow-up to guide the development of otomycosis guidelines to overcome some of the weaknesses found in the literature.<\/jats:p><jats:p><jats:bold>Systematic Review Registration:<\/jats:bold><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/#myprospero<\/jats:ext-link>.<\/jats:p>","DOI":"10.3389\/fsurg.2021.739360","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T10:48:30Z","timestamp":1640170110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["A Comparison of Antifungal Drugs and Traditional Antiseptic Medication for Otomycosis Treatment: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"8","author":[{"given":"Shunyu","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunzhang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhai","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"331","DOI":"10.18502\/ijph.v48i2.832","article-title":"Investigation of etiologic agents and clinical presentations of otomycosis at a tertiary referral center in Tehran, Iran","volume":"48","author":"Kamali Sarwestani","year":"2019","journal-title":"Iran J Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"60","DOI":"10.17116\/otorino20208501160","article-title":"Fungal otitis externa in children: principles of diagnosis and rational therapy","volume":"85","author":"Kryukov","year":"2020","journal-title":"Vestn Otorinolaringol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jiph.2019.08.007","article-title":"Recent trends in the epidemiology, diagnosis, treatment, and mechanisms of resistance in clinical Aspergillus species: a general review with a special focus on the Middle Eastern and North African region","volume":"13","author":"Zakaria","year":"2020","journal-title":"J Infect Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"876","DOI":"10.3201\/eid2605.191588","article-title":"Clinical outcomes of patients treated for Candida auris infections in a multisite health system, Illinois, USA","volume":"26","author":"Arensman","year":"2020","journal-title":"Emerg Infect Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"566","DOI":"10.5999\/aps.2019.00290","article-title":"Earwax of patients with hidradenitis suppurativa: a retrospective study","volume":"46","author":"Shibuya","year":"2019","journal-title":"Arch Plast Surg."},{"key":"B6","doi-asserted-by":"publisher","first-page":"98","DOI":"10.5152\/iao.2020.7709","article-title":"Malignant otitis externa: causes for various treatment responses","volume":"16","author":"Arsovic","year":"2020","journal-title":"J Int Adv Otol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1177\/014556131209100308","article-title":"Otomycosis in immunocompetent and immunocompromised patients: comparative study and literature review","volume":"91","author":"Viswanatha","year":"2012","journal-title":"Ear Nose Throat J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1111\/j.1439-0507.2011.02132.x","article-title":"Otomycosis in Shanghai: aetiology, clinical features and therapy","volume":"55","author":"Jia","year":"2012","journal-title":"Mycoses."},{"key":"B9","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1111\/j.1439-0507.2007.01441.x","article-title":"Otomycosis in Western Nigeria","volume":"51","author":"Fasunla","year":"2008","journal-title":"Mycoses."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1007\/s00405-020-05917-9","article-title":"Fungal otitis externa and wet ear with mucopurulent should be a influencing factors on tympanic membrane closure","volume":"277","author":"Van Stekelenburg","year":"2020","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"239730","DOI":"10.1155\/2013\/239730","article-title":"Effectiveness of 7.5 percent povidone iodine in comparison to 1 percent clotrimazole with lignocaine in the treatment of otomycosis","volume":"2013","author":"Philip","year":"2013","journal-title":"ISRN Otolaryngol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.32412\/pjohns.v24i1.701","article-title":"A preliminary study on the efficacy of Plumeria acuminata (Kalachuchi) bark extract ointment vs. clotrimazole cream in the treatment of otomycosis","volume":"24","author":"Boncalon","year":"2009","journal-title":"Philipp J Otolaryngol Head Neck Surg."},{"key":"B13","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1046\/j.0933-7407.2001.00682.x","article-title":"Otomycosis in Nigeria: treatment with mercurochrome","volume":"44","author":"Mgbor","year":"2001","journal-title":"Mycoses."},{"key":"B14","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/j.bjorl.2017.04.004","article-title":"Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment","volume":"84","author":"Mofatteh","year":"2018","journal-title":"Braz J Otorhinolaryngol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1017\/S0022215116008598","article-title":"Effectiveness of 3 per cent boric acid in 70 per cent alcohol vs. 1 per cent clotrimazole solution in otomycosis patients: a randomised, controlled trial","volume":"130","author":"Romsaithong","year":"2016","journal-title":"J Laryngol Otol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.mycmed.2017.11.006","article-title":"Povidone iodine soaked gelfoam for the treatment of recalcitrant otomycosis - Our experiences at a tertiary care teaching hospital of Eastern India","volume":"28","author":"Swain","year":"2018","journal-title":"J Mycol Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1080\/00016489.2020.1712474","article-title":"Efficacy and safety of terbinafine hydrochloride spray and 3% boric acid alcohol ear drops in otomycosis","volume":"140","author":"Xu","year":"2020","journal-title":"Acta Otolaryngol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1007\/s00405-013-2486-0","article-title":"Otomycosis in the North of Iran: common pathogens and resistance to antifungal agents","volume":"271","author":"Nemati","year":"2014","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s15010-020-01394-8","article-title":"Aspergillus flavus malignant external otitis in a diabetic patient: case report and literature review","volume":"48","author":"Pichon","year":"2020","journal-title":"Infection."},{"key":"B20","doi-asserted-by":"publisher","first-page":"5269535","DOI":"10.1155\/2019\/5269535","article-title":"Role of clotrimazole in prevention of recurrent otomycosis","volume":"2019","author":"Kiakojuri","year":"2019","journal-title":"Biomed Res Int."},{"key":"B21","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1017\/S0022215117002237","article-title":"Necrotising otitis externa in the immunocompetent patient: case series","volume":"132","author":"Unadkat","year":"2018","journal-title":"J Laryngol Otol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.3889\/oamjms.2019.176","article-title":"Outer ear infections in Iran: a review","volume":"7","author":"Kiakojuri","year":"2019","journal-title":"Open Access Maced J Med Sci."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.739360\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T10:48:32Z","timestamp":1640170112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.739360\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":22,"alternative-id":["10.3389\/fsurg.2021.739360"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2021.739360","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]},"article-number":"739360"}}