Clinical Features and Risk Factors of Otomycosis: A Case-Control Study

Objective: This study aimed to investigate the clinical features and risk factors of otomycosis. Methods: A case-control study included 160 patients with otomycosis as the case group and 320 healthy individuals as the control group. Clinical data were collected through a standardized questionnaire, including habitual ear picking, ear cleaning at salons, swimming habits, use of earphones/hearing aids, external auditory canal stenosis, and presence of diabetes. Binary logistic regression analysis was used to determine the risk factors. Results: The most common symptom was ear fullness/blockage (28.3%). Otoscopic examination before debridement most frequently revealed external auditory canal secretions (45.2%). Aspergillus species were the predominant pathogens, accounting for 80.0% of cases. Binary multivariable logistic regression analysis identified the following as significant risk factors for otomycosis: habitual ear picking (OR = 2.748, 95% CI: 1.669-4.525, P < .001), ear cleaning at salons (OR = 7.434, 95% CI: 3.023-18.281, P < .001), and external auditory canal stenosis (OR = 3.737, 95% CI: 2.384-5.857, P < .001). Swimming habits, frequent use of earphones/hearing aids, and diabetes were not significantly associated with otomycosis. Conclusion: Frequent ear picking, ear cleaning at salons, and external auditory canal stenosis are major risk factors for otomycosis.