Research Article

Black fungus due to covid-19: audiological assessment of middle ear functioning

Abstract

Background and Aim: A rare fungal infection, mucormycosis, has become more common in patients recovering from COVID in its second wave in India. The proximity and easy access to the middle ear through the Eustachian tube from paranasal sinuses alarms the need for early detection of middle ear involvement. Hence, the study was carried out to determine the influence of mucormycosis on Immittance and otoacoustic emissions.
Methods: eleven rhino orbital mucormycosis patients aged 40-60 years participated in the study. Middle ear evaluation was carried out with the help of Immittance and otoacoustic emissions.
Results: It was found that 4/11 (36.36%) participants had abnormal Immittance and absent otoacoustic emissions, indicating middle ear dysfunction. 3/4 participants had middle ear dysfunction in the ear ipsilateral to the side of the infection.
Conclusion: The study results reveal a rare chance of middle ear involvement in mucormycosis patients, which calls for the crucial role of the audiologist in the early detection of middle ear dysfunction.

1. Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends Hear. 2014;18:233121651454136. doi: 10.1177/2331216514541361
2. Thrasher RD, Kingdom TT. Fungal infections of the head and neck: an update. Otolaryngol Clin North Am. 2003;36(4):577–94. doi: 10.1016/s0030-6665(03)00029-x
3. Rutt AL Sataloff RT. Aspergillusotomycosis in an immu¬nocompromised patient. Ear Nose Throat J. 2008;87(11):622-3. doi: 10.1177/014556130808701107
4. Gandra S, Ram S, Levitz SM. The “black fungus” in India: The emerging syndemic of COVID-19-associated mucormycosis. Ann Intern Med. 2021;M21-2354. doi: 10.7326/M21-2354
5. Singh AK, Singh R, Joshi SR, Misra A. Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes Metab Syndr. 2021;15(4):102146. doi: 10.1016/j.dsx.2021.05.019
6. Tuzcu A, Bahceci M, Celen MK, Kilinc N, Ozmen S. Necrotizing (malignant) otitis externa: An unusual localization of mucormycosis. Indian J Med Microbiol. 2006;24(4):289-91. doi: 10.4103/0255-0857.29390
7. Hazarika P, Zachariah J, Victor J, John M, Devi C, Abraham P. Mucormycosis of the middle ear: a case report with review of literature. Indian J Otolaryngol Head Neck Surg. 2012;64(1):90-4. doi: 10.1007/s12070-011-0156-3
8. Yun MW, Lui CC, Chen WJ. Facial paralysis secondary to tympanic mucormycosis: case report. Am J Otol. 1994;15(3):413-4.
9. Raza AF, Paudel DR, Prabhu P. Black fungus and COVID-19: role of otorhinolaryngologists and audiologists. Eur Arch Otorhinolaryngol. 2021;278(8):3133-4. doi: 10.1007/s00405-021-06932-0
10. Jacobson JT. The role of Immittance audiometry in detecting middle ear disease. Can Fam Physician. 1981;27:103-9.
11. Kopala W, Kukwa A. Evaluation of the acoustic (stapedius) reflex test in children and adolescents with peripheral facial nerve palsy. Int J Pediatr Otorhinolaryngol. 2016;89:102-6. doi: 10.1016/j.ijporl.2016.08.001
12. Nozza RJ, Sabo DL, Mandel EM. A role for otoacoustic emissions in screening for hearing impairement and middle ear disorders in school-age children. Ear Hear. 1997;18(3):227-39. doi: 10.1097/00003446-199706000-00006
13. Garcia MV, de Azevedo MF, Testa JR. Accoustic immitance measures in infants with 226 and 1000 Hz probes: correlation with otoacoustic emissions and otoscopy examination. Braz J Otorhinolaryngol. 2009;75(1):80-9. doi: 10.1016/s1808-8694(15)30836-3
14. Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24. doi: 10.1001/archotol.1970.04310040005002
15. Biniyam K, Bhat V, Bhandary SKB, Aroor R. Asympto¬matic mucormycosis of middle ear: An incidental finding during tympanoplasty. Indian J Otol. 2014;20(2):83-5. doi: 10.4103/0971-7749.131875
16. Kermani W, Bouttay R, Belcadhi M, Zaghouani H, Ben Ali M, Abdelkéfi M. ENT mucormycosis. Report of 4 cases. Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(2):83-6. doi: 10.1016/j.anorl.2015.08.027
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IssueVol 30 No 4 (2021) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/avr.v30i4.7450
Keywords
Mucormycosis immittance otoacoustic emissions
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How to Cite
1.
Kumar P, Goyal S, Prabhu P. Black fungus due to covid-19: audiological assessment of middle ear functioning. Aud Vestib Res. 2021;30(4):300-305.