Fungal infections of the auditory canal and middle ear are usually left unnoticed and regarded as a harmless saprophytic growth. However, these infections may become clinically significant in immunocompromised patients or patients undergoing long-term antibiotic treatment. This is demonstrated by characteristic case reports and confirmed by light and electron microscopic findings. Moreover, studies on animals with experimentally induced fungal infections have furnished evidence for the risk of the infection's spreading to the inner ear and causing serious damage to the organ of Corti; indirect damage to these structures by mycotoxins cannot be ruled out. To avoid complications of such severity of an allegedly harmless otomycosis we consider a quick and clinically easy to perform local treatment of high-risk patients as absolutely necessary. Such a treatment using bifonazole solution or cream was carried out on a number of patients and proved to be effective and free from side effects.