Empirical Treatment Approach for Itchy Ear Syndrome: Topical Steroids or Antifungals?

Background: “Itchy ear syndrome”, defined as ear itching after exclusion of related pathologies with a thorough physical examination, is common in otolaryngology practice. Despite the fact that it is frequent, high quality evidence regarding its etiology and treatment is lacking. We aimed to investigate whether empirical antifungal therapy is effective in this situation in comparison with corticosteroid therapy and the effectiveness of topical mometasone furoate lotion. Methods: This retrospective observational study included 57 patients who applied with recurrent ear pruritus, were treated with mometasone or ciclopirox olamine, and who did not have any pathological findings on examination. The patients were retrospectively scanned through the hospital database, called, and asked to fill out a modified form of the 5D itching questionnaire to assess the degree of itching before and after treatment. The results were compared statistically. Results: Of the 57 patients included, 25 (43.8%) were male and 32 (56.1%) were female. The mean age of the two groups was similar (p=0.915). Twenty-eight (49.1%) patients were treated with ciclopirox olamine, and 29 (50.9%) patients with mometasone. When the scores before and after treatment were compared, the decrease in scores was significant (p<0.001). There was no significant difference between the two cohorts regarding pre-treatment and post-treatment scores (p=0,26 and p=0.22, respectively). Conclusion: Our findings indicate that topical antifungal treatment with ciclopirox olamine and topical steroid treatment with lotion form mometasone furoate are both effective in the treatment of itchy ear syndrome.