FIVE KEY POINTS
Otomycosis can account for up to 20% of ENT outpatient consultations in some regions
Aspergillus and Candida species are the frequent culprits
Tympanic membrane perforation is an infrequently reported feature of otomycosis which physicians are not always aware of, but yet is not uncommon
Ear toilet is an important initial step in the management of otomycosis
Specific antiseptics have a useful role. Clotrimazole remains a workhorse antifungal, but other antifungals may be needed against resistant species and in immunocompromised patients