In recent years, there has been a gradual increase in fungal diseases of the external auditory canal, especially in the coastal areas of Guangdong, which may be related to the hot and humid climate, moisture in the external auditory canal (swimming, bathing, sauna, pus in the middle ear), damage caused by the application of unclean objects to dig the ear, and increased systemic and local use of antibiotics and hormones. There are many types of fungi that cause the disease, with Aspergillus, Candida, Penicillium and Trichoderma being the most common. If scabs or secretions block the external auditory canal or cover the surface of the eardrum, hearing loss and tinnitus may occur; if there is bacterial infection, it may cause swelling and pus in the external auditory canal. On examination, we can see that there is grayish white, earthy yellow or smoky gray mold moss in the deep part of the external auditory canal, which looks like a film or fan, very similar to mold; when the moss film is removed, we can see that the skin of the external auditory canal is congested and swollen, with mild erosion or a small amount of blood oozing. To treat external ear canal fungal disease, the first step should be to thoroughly remove the scabs and secretions from the external ear canal. Depending on the situation, cerumen hooks, lance forceps, cotton rolls or suction devices can be used to clean the external auditory canal. If the scab is hard to remove, soak it in 3% hydrogen peroxide or 5% sodium bicarbonate for 30 minutes before cleaning it up. Topical medication is more effective, and systemic antifungal medication is needed only in severe cases. Topical medication is only effective when it is used after the external auditory canal is thoroughly cleaned of foul secretions. The current local treatment methods for external ear canal fungal disease are: 1. Ear drops: commonly used drugs include boric acid alcohol, salicylic acid alcohol, fluconazole eye drops, etc. However, there are disadvantages such as local irritation, not easy to prepare and preserve or unsatisfactory efficacy. 2.Drug gauze or tampon filling: the method has different efficacy due to different drugs, and the preparation of gauze or tampon has certain requirements. 3, ointment coating: commonly used trimethoprim econazole cream, compound ketoconazole cream, etc. Clinical research data show that trimethoprim econazole cream topical application to the external auditory canal has the following advantages: 1, reasonable method, significant and accurate efficacy; 2, low local absorption and low side effects; 3, small local irritation, good adsorption, long duration of action, easily accepted by patients; 4, simple method, inexpensive, short course of treatment. During the treatment process, it should be noted that the external ear canal should be kept dry, and the external ear canal should be cleaned before each application. It is best for the doctor to personally apply the drug evenly to all lesions to form a thin layer, so as to avoid the efficacy of the treatment being affected by the patient’s own application due to the inappropriate effect of the drug. For those with tympanic membrane perforation, caution should be exercised and timely follow-up should be noted.