Dear Doctor,
I have an ear condition that is probably categorized as chronic/acute otitis media, where I have a constant clicking sound in my ears. My eustachian tube is constricted due to nasal allergies, which are being treated separately by an allergist. Since I was a child I have had extreme sensitivity to yeast (or candida albicans). When I ate cantaloupe, my ears would immediately become inflammed, itch, and I would temporarily lose hearing. I was previously treated by an allergist w/ monillia shots, which caused a severe reaction in my ears during a tennis match where I lost hearing for about 36 hours and my ears discharged an orange fluid. Ten years have past since that event and I am still suffering. I just went to an ENT doctor, and tubes were placed in my ears. One ear improved slightly, the other has lost audible clarity. I'm spinning my wheels.
The question I want to raise is "What role can or does yeast or fungis play in otitis media and eustachian tube dysfunction, and are there topical drops that can be applied in the ear to negate their effects?
Reply: --------------
First of all it is important to distinguish between an actual primary infection caused by yeast, versus a secondary overgrowth of yeast related to prior antibiotic treatment, versus manifestations of an allergic process related to yeast.
Actual primary yeast or fungal infections of the ear, eustachian tube, or any other mucous membrane of the upper respiratory tract are usually associated with serious underlying illness, often associated with suppression of normal immune system function. Such conditions therefore are typically seen only in the seriously ill. Treatment of such yeast or fungal infections would require intravenous anti-fungal agents.
Secondary overgrowth of yeast or fungus in the upper respiratory or upper digestive tract can be seen following administration of antibiotics. An example would be the development of thrush in the mouth following a course of powerful antibiotics used to treat a sinus infection. This type of condition occurs because there is a certain amount of yeast that cohabitates with normal flora in the upper respiratory and digestive tract. The yeast and normal bacterial flora compete for nutrients thereby controlling their respective populations. When antibiotics are administered, which can kill normal bacteria as well as infective bacteria, yeast is left to grow unchecked since yeast is not killed by antibiotics. Secondary yeast growth in the ear can occasionally be seen with chronic infectious ear conditions such as chronic otitis media where there is a perforation of the ear drum and chronic drainage that requires frequent use of topical antibiotic drops. Such secondary yeast conditions in the ear occasionally require topical anti-candidal medications.
Hypersensitivity to yeast on the other hand is not an infection but rather an allergic manifestation. While it may theoretically be possible to eliminate or reduce the population of yeast by the administration of anti-candidal medications, the resolution of the allergic manifestations would necessitate continued and chronic use of such medications for this approach does not affect the actual hypersensitivity. In other words, if the anti-candidal medication is discontinued, yeast is ubiquitous enough that re-exposure would occur resulting in recurrence of the hypersensitivity reactions. It is doubtful that symptoms isolated to the ear or eustachian tube would be caused by a yeast hypersensitivity.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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