MYRINGOMYCOSIS

Synonyms.—Myringomycosis aspergillina; Mycomyringitis; Otomycosis; Otitis
externa parasitica; Fungous disease of the external ear.

Wreden, in 1867, following the observations of Mayer, in 1844,
and Paccini, in 1851, as to the existence of fungi in the external auditory
canal, was the first to call particular attention to this affection, and al­
though still of somewhat obscure nature, the later writings by Politzer
and Gruber, and in this country by J. O. Green, Roosa, Burnett, and
Barclay, have, especially those by the last two, added materially to our
knowledge concerning it.¹ Its chief characters consist of a scurfy, moist-
looking, blotting-paper-like coating, of a dirty gray or brownish-gray
color, with commonly here and there slightly raised, yellowish, brownish,
greenish, or blackish points or spots. It is often distinctly moist, and may
exhibit a candied-looking or glazed surface, due to the serous effusion
provoked. This latter is sometimes present in considerable quantity.
The whole canal, including the drum, may be involved, although not
infrequently only parts of the meatus are apparently the seat of the
disease, the drum being implicated to but a slight degree. It is generally
believed, however, that the drum is primarily attacked, and from here
it extends along the canal. The former may in some instances be so much
damaged as to result in perforation. If the scales or crusts are forcibly
removed, the underlying surface is ordinarily noted to be more or less
abraded and raw looking, bleeding easily. The first symptoms consist
of itchiness, stinging, sometimes slight or great pain, and a variable
impairment of hearing, usually together with a scanty watery discharge.
While there is some difference of opinion as to the specific fungus, it is the
common belief that the malady is due to the aspergillus niger and the
aspergillus glaucus.

There is no tendency to spontaneous disappearance. If neglected,
a variable degree of deafness or permanent damage may result.

¹ Burnett, Amer. Jour. Otology, 1879, vol. i, PP. 10 and 93 (a report of 20 cases
with review of the subject and references); Barclay, in Burnett’s System of Diseases of
the Ear, Nose, and Throat, 1893, vol. i, p. 190 (with review and references).

ACTINOMYCOSIS

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Treatment consists in an occasional syringing with a weak alkaline
solution to remove the fungus and other accumulations, and the applica­
tion of a mild parasiticide, such as a 1 per cent, solution of sodium hy­
posulphite (Burnett) and of alcohol full strength or weakened (Löwen-
berg). Ointments may have to be used occasionally, if needed to soften
any accumulation, but are to be avoided when possible, as, according to
Bezold, fatty matter favors the growth of the fungus. When deeply
seated or seriously involving the drum, the case belongs more properly
to the aurist.

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