Evaluation and management of ear itching: our experience
Keywords:Aetiology, Ear itching, Management, Diabetes
Background: Itching of ear is a common presenting symptom in clinical practice. Ear itching has many underlying causes which needs detailed evaluation. The aim of the study was to determine the incidence of ear itch and the aetiological factors and various management options associated with ear itch.
Methods: A retrospective observational cohort study was done in two centres over a period of one year in patients with ear itch in ENT outpatient were included. Sampling method used was systematic sampling. The details regarding the age, gender and co-morbidities of the patients were recorded. The ear was clinically examined.
Results: A total of 2143 patients presented to outpatient, 210 (9.8%) presented with ear itching. The mean age (SD) of the study patients were 46.8 years (15.6). The gender distribution showed a male:female of 1:1. Comorbidities included hypertension (27.14%), diabetes (8.57%) and combination of both in 8.1%. Mean±SD of duration of study subjects was 4.3±1.6 months. The common aetiologies were otomycosis (30%), wax deposition (25.24%) and otitis externa (14.29%). Diabetes was predominantly associated with otomycosis (68.57%, p<0.0001). In our study, prevalence of ear itching was 9.8% with common aetiologies were otomycosis, wax deposition and otitis externa. There was significant association of diabetes mellitus with otomycosis.
Conclusions: Ear itching is a symptom that needs detailed history, careful clinical evaluation and management. Patient’s quality of life will largely improve if ear itching is dealt with all possible aetiologies and appropriate management.
Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009;(3):7076.
Yamaura K, Doi R, Suwa E, Ueno K. Repeated application of glucocorticoids exacerbate pruritus via inhibition of prostaglandin D2 production of mast cells in a murine model of allergic contact dermatitis. J Toxicol Sci. 2012;37(6):1127-34.
Summey B. Pruritus. In: Walsh DT, Caraceni AT, Fainsinger R, eds. Palliative Medicine. Philadelphia: Saunders Elsevier; 2009: 910-913.
Oztürkcan S, Oztürkcan S. Dermatologic diseases of the external ear. Clin Dermatol. 2014;32(1):141-52.
Barati B, Okhovvat SA, Goljanian A, Omrani MR. Otomycosis in central Iran: a clinical and mycological study. Iran Red Crescent Med J. 2011;13(12):873-6.
Adoubryn KD, Gattia VK, Yapo GC, Nigué L, Zika DK, Ouhon J. Epidemiology of otomycoses at the University Hospital of Yopougon (Abidjan-Ivory Coast). J Mycol Med. 2014;24(2):9-15.
Kazemi A, Majidinia M, Jaafari A, Ayatollahi MSA, Zarei MA, Alikhah H. Etiologic Agents of Otomycosis in the North-Western Area of Iran. Jundishapur J Microbiol. 2015;8(9):21776.
Abdelazeem M, Gamea A, Mubarak H, Elzawawy N. Epidemiology, causative agents, and risk factors affecting human otomycosis infections. Turk J Med Sci. 2015;45(4):820-6.
Jia X, Liang Q, Chi F, Cao W. Otomycosis in Shanghai: aetiology, clinical features and therapy. Mycoses. 2012;55(5):404-9.
Fullington D, Song J, Gilles A, Guo X, Hua W, Anderson CE, et al. Evaluation of the safety and efficacy of a novel product for the removal of impacted human cerumen. BMC Ear Nose Throat Disord. 2017;17:5.
Siemens W, Xander C, Meerpohl JJ, Buroh S, Antes G, Schwarzer G, Becker G. Pharmacological interventions for pruritus in adult palliative care patients. Cochrane Database Syst Rev. 2016;11(11):8320.
Sangaré I, Amona FM, Ouedraogo RW, Zida A, Ouedraogo MS. Otomycosis in Africa: Epidemiology, diagnosis and treatment. J Mycol Med. 2021;31(2):101115.
Gharaghani M, Seifi Z, Zarei Mahmoudabadi A. Otomycosis in iran: a review. Mycopathologia. 2015;179(5):415-24.
Taheri A, Mehmandari SN, Shahidi M, Mehdizadeh H, Mirlohi SMJ, Aref NM, et al. Popularity and Harms of Aural Foreign Bodies: A Descriptive Study of Patients in Baqiyatallah University Hospital, Tehran, Iran. Int Tinnitus J. 2017;21(2):31-5.
Madsen EF, Larsen J, Flink PO. Itching in the external ear--a side effect of ear plugs. Ugeskr Laeger. 1991;153(30):2125-8.
Kamali SH, Daie GR, Hashemi SJ, Rezaie S, Gerami SM, Mahmoudi S, et al. Investigation of Etiologic Agents and Clinical Presentations of Otomycosis at a Tertiary Referral Center in Tehran, Iran. Iran J Public Health. 2019;48(2):331-7.
Lee YH, Suh KD, Mun SK. A man with an itchy auricular mass lesion. Aust J Gen Pract. 2018;47(11):785-6.
Košec A, Kostić M, Ajduk J, Ries M. Hypertrophic recurring lichen planus of the external auditory canal. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(2):123-6.
Valinotti JC, Bruce AJ, Krotova Khan Y, Beatty CW. A 10-year review of otic lichen planus: the Mayo Clinic experience. JAMA Dermatol. 2013;149(9):1082-6.
Kassi K, Kouame K, Kouassi A, Allou A, Kouassi I, Kourouma S, Ecra E, et al. Quality of life in black African patients with keloid scars. Dermatol Reports. 2020;12(2):8312.
Huang JT, Mallon K, Hamill S, Ohlms LA, Liang MG. Frequency of ear symptoms and hearing loss in ichthyosis: a pilot survey study. Pediatr Dermatol. 2014;31(3):276-80.
Pentyala S, Mysore P, Moller D, Pentyala S, Kardovich R, Martino A, Proothi M. Temporomandibular joint disorder and inner ear pruritus: resolution by eminectomy. J Craniofac Surg. 2014;25(5):1840-2.
He G, Xu Y, Zhu Z. Clinical analysis of pediatric primary external auditory canal cholesteatoma. Int J Pediatr Otorhinolaryngol. 2019;118:25-30.
Fox News. Ear itching turns out to be rare case of mites for man, 2012. Available at: https://www.foxnews.com/health/ Accessed on 15 July 2021.
Puri S, Dornhoffer JL, North PE. Contact dermatitis to silicone after cochlear implantation. Laryngoscope. 2005;115(10):1760-2.
Phamduy TT, Young DM, Ramolia PB. Localized Scarlatiniform Rash of the Ears and Antecubital Fossa in COVID-19. J Am Board Fam Med. 2021;34:183-5.
Yamaura K, Doi R, Suwa E, Ueno K. A novel animal model of pruritus induced by successive application of glucocorticoid to mouse skin. J Toxicol Sci. 2011;36(4):395-401.
Osguthorpe JD, Nielsen DR. Otitis externa: Review and clinical update. Am Fam Physician. 2006;74(9):1510-6.
Djalilian, HR. Symptom, itchy ear. Hearing J. 2014;67(9):8-11.
Woodley N, Mohd SMA, Tikka T, Locke RR. Not 'just' a foreign body in the ear canal. BMJ Case Rep. 2019;12(4):229302.
Adoga AS, Iduh AA. Otomycosis in Jos: Predisposing factors and Management. Afr J Med Med Sci. 2014;43(1):209-13.
Anwar K, Gohar MS. Otomycosis; clinical features, predisposing factors and treatment implications. Pak J Med Sci. 2014;30(3):564-7.