Vol. 7, Issue 1, Part A (2025)

Background: Otomycosis is a fungal infection of the external auditory canal, affecting 9% to 30% of the global population. Although not life-threatening, otomycosis is challenging to treat due to high recurrence and antifungal resistance. Topical antifungals, such as clotrimazole and nystatin, are standard treatments, often combined with steroids or antiseptics. Voriconazole, a newer antifungal, has shown promise for refractory cases due to its broad spectrum and strong anti-Aspergillus activity. However, research on its optimal use in otomycosis remains limited.

Objective: While a systematic review exists for fungal keratitis, none have assessed voriconazole for otomycosis. Therefore, a systematic study was conducted to evaluate its effectiveness in treating refractory otomycosis.

Methods: We conducted a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search in PubMed, Scopus, ScienceDirect, and Google Scholar was conducted from inception to February 2025. Duplicate publications, review articles, and incomplete articles were excluded. The database searches identified a total of 1400 articles. A thorough review of the abstracts and titles led to the exclusion of 862 items.

Results: Finally, we identified 5 articles through full-text reading and analysis, which included 89 cases. All reported cases were successfully treated with voriconazole.

Conclusion: Voriconazole appears to be a potentially effective treatment, especially for refractory cases of otomycosis.