Clinical efficacy observation of different administration frequencies of triamcinolone acetonide and econazole cream for fungal otitis externa

Pan Kuilian; Wang Guoqing; Liu Qingshan; Liu Guangliang; Ji Li; Wang Liang; Liu Zhongyi

doi:10.11986/j.issn.1673-873X.2025.04.10

Abstract：Objective To investigate the clinical efficacy of different administration frequencies(once every 7 days,once every 4 days,once every 2 days)of triamcinolone acetonide and econazole cream for fungal otitis externa(FOE),providing references for clinical treatment.Methods A total of 105 FOE patients admitted to Xuancheng People's Hospital from June 2020 to June 2023 were randomized into three groups(n=35 each).All patients underwent otoscopic external auditory canal cleaning fol-lowed by topical application of triamcinolone acetonide and econazole cream.Administration frequencies were:control group(once every 7 days),observation group 1(once every 4 days),and observation group 2(once every 2 days)for 2 weeks.Pa-tients were re-examined every 2 days,with prompt cleaning if secretions appeared.Recurrences during treatment received an additional 3 weeks of the original therapy by the same physician.Therapeutic efficacy after 2 weeks,time to symptom relief,recurrence rates at 2 weeks,4 weeks,3 months,and 6 months post-treatment were compared.Additionally,air conduction hearing threshold and bone conduction hearing threshold difference values before/after treatment,hearing classification before/after treatment,and adverse reactions during treatment were compared between the three groups.Results Overall response rates were significantly higher in observation group 1(91.43%)and group 2(94.29%)than in the control group(74.29%)(P<0.05).Relief times for ear itching,fullness sensation,hearing loss,and otorrhea were significantly shorter in observation groups 1 and 2 compared with the control group(P<0.05),with no significant difference between observation groups(P>0.05).No intergroup differences were noted in recurrence rates at 2 weeks,4 weeks,3 months,or 6 months(P>0.05).Sig-nificant differences in air conduction hearing threshold difference and bone conduction hearing threshold difference were ob-served before and after treatment among the three groups(P<0.05);the air conduction hearing threshold and bone conduction hearing threshold difference values were significantly higher in the observation group 1 and the observation group 2 than in the control group(P<0.05).The American Academy of Otolaryngology-Head and Neck Surgery(AAO-HNS)hearing classifica-tions differed significantly between groups(P<0.05).Adverse reaction rates showed no significant difference between groups(P>0.05).Conclusion Otoscopic external auditory canal cleaning combined with once-weekly administration of triamcinolone acetonide and econazole cream shows suboptimal efficacy.Both once every 4 days and once every 2 days regimens similarly im-prove symptoms,including ear itching,fullness,and hearing loss,with good clinical efficacy.