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Background: Otomycosis affects about 9% of patients with otitis externa. One of the predisposing factor is impacted cerumen.  Earphone usage causes cerumen impaction. In the light of the recent COVID-19 pandemic, people are housebound due to prolonged lockdown. Hence people are more technology dependent as working from home and studying online has become the norm. Therefore, usage of earphones has proportionately increased, and the impacted cerumen cases have increased. Methods: This cross-sectional study aimed to analyze data from questionnaire to assess the prevalence of otomycosis among patients with impacted cerumen due to excessive earphone usage, establish associations between otomycosis and symptoms such as pain and hearing loss as well as the correlation between fungal growth and the long hours of earphones usage. The relationship between the age of participants and the usage of earphones during the pandemic was also explored. The data was collected from 100 individuals aged 14 to 51 years who sought treatment for symptomatic impacted wax at an ENT clinic in Malaysia. Results: The mean age of participants was 25.9 years. There was a 31% prevalence of otomycosis among these patients. Otalgia was present in 60% of patients with otomycosis (t value 2.94, coefficient 0.27). Approximately 37% of patients had a large air-bone gap indicating conductive hearing loss. There was an insignificant correlation between otomycosis and the longer hours of earphones usage (t value 1.51, coefficient 0.00015). No correlation was found between age of participants and the total hours of earphone usage (t value 0.63, coefficient 0.0012). Conclusion: This study offers initial evidence that earphone usage could be a predisposing factor in developing otomycosis. However, there was no evidence of longer hours of earphones usage increasing the chances of developing otomycosis. Additionally, symptoms like otalgia and conductive hearing loss could be present in both earwax impaction and otomycosis.

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Suresh, S., Suresh, S., & Sivasamy, S. (2021). Prevalence of otomycosis in patients with cerumen impaction due to ear-phone usage during COVID-19. Indonesian Journal of Medical Sciences and Public Health , 2(1), 28-39.


1. Ho T, Vrabec JT, Yoo D, Coker NJ. Otomycosis: Clin-ical features and treatment implications. Otolaryn-gology–Head and Neck Surgery. 2006;135(5):787-791. doi:10.1016/j.otohns.2006.07.008
2. Kaur R, Mittal N, Kakkar M, Aggarwal AK, Mathur MD. Otomycosis; a clinicomycologic study. Ear Nose Throat J. 2000;79(8):606–960.
3. VennevaldI , Schonlebe J, Klemm E. Mycological and histological investigations in Humans with middle ear infections. Mycoses. 2003;46(1-2):12–18.
4. Stern JC, Lucente FE. Otomycosis. Ear Nose Throat J. 1988 Nov;67(11):804-5, 809-10. PMID: 3073938.
5. Meirtusovas , Simaljakova M. Yeast and fungi iso-lated at the mycology laboratory of the First Der-matology Clinic of the Medical Faculty Hospital of Comenens University in Bratislava (1995-2000) Epidermoil Microbial Immunal. 2003;52:76–80.
6. Mahmoudabadi AZ. Mycological Studies in 15 cas-es of otomycosis. Pak J Med Sci. 2006;22(4):486–488.
7. Anwar K, Gohar MS. Otomycosis; clinical features, predisposing factors and treatment implications. Pak J Med Sci. 2014;30(3):564-567. doi:10.12669/pjms.303.4106
8. Dubey, A., & Tripathi, S. (2020). Analysing the Sen-timents towards Work-From-Home Experience during COVID-19 Pandemic. Journal Of Innovation Management, 8(1).
9. Rasmitadila, R., Aliyyah, R., Rachmadtullah, R., Samsudin, A., Syaodih, E., Nurtanto, M., & Tambu-nan, A. (2020). The Perceptions of Primary School Teachers of Online Learning during the COVID-19 Pandemic Period: A Case Study in Indonesia. Jour-nal Of Ethnic And Cultural Studies, 7(2), 90.
10. Dey, S., & Dey, I. (2020). Health concerns during lockdown: an observational study among adults of West Bengal. International Journal Of Community Medicine And Public Health, 7(9), 3674.
11. Zia, S., Tahir, H., Azeem, K., Adil, S., Shehzad, A., & Shah, M. (2019). FREQUENCY AND FACTORS OF EAR INFECTION AMONG SWIMMERS, COTTON BUD AND HEADPHONE USERS. Pakistan Journal Of Public Health, 9(1), 15-18.
12. Mazlan R, Saim L, Thomas A, Said R, Liyab B. Ear infection and hearing loss amongst headphone us-ers. Malays J Med Sci. 2002;9(2):17-22.
13. Senturia BH, Marcus MD, Lucente FE. Diseases of the External Ear-An Otologic-Dormatologic Manu-al. New York: Grune & Stratton; 1980.
14. Sharma S. Hazards of Earphone Usage among ado-lescent. IP Journal of Paediatrics and Nursing Sci-ence, April-June, 2019;2(2):60-62
15. Harrison, E., & Cronin, M. (2016). Otalgia. Australi-an Family Physician, 45(7), 493–497.
16. Shah, Rahul K et al. Otalgia. Otolaryngologic Clinics of North America, Volume 36, Issue 6, 1137 – 1151
17. Noise and Hearing Loss. NIH Consensus Statement Jan 22–24. 1990;8(1):1–24.
18. Subha ST, Raman R. Role of Impacted Cerumen in Hearing Loss. Ear, Nose & Throat Journal. 2006;85(10):650-653. doi:10.1177/014556130608501011
19. Biau DJ, Kernéis S, Porcher R. Statistics in brief: the importance of sample size in the planning and in-terpretation of medical research. Clin Orthop Relat Res 2008; 466(9): 2282-8.
20. Norton BJ, Strube MJ. Understanding statistical power. J Orthop Sports Phys Ther 2001; 31(6): 307-15.
21. Wang MC, Yang Y. Complexity and bias in cross-sectional data with binary disease outcome in ob-servational studies. Stat Med 2021; 40(4): 950-62.
22. Wang X, Cheng Z. Cross-Sectional Studies: Strengths, Weaknesses, and Recommendations. Chest 2020; 158(1S): S65-S71.
23. Pannucci CJ, Wilkins EG. Identifying and avoiding bias in research. Plast Reconstr Surg 2010; 126(2): 619-25 ]