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New Insights into Eosinophilic Otitis Media

  • Otitis (D Skoner, Section Editor)
  • Published:
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Abstract

Eosinophilic otitis media (EOM) is a type of intractable otitis media that occurs mainly in patients with bronchial asthma (BA). In 2011, the diagnostic criteria for EOM were established. EOM is characterized by the presence of a highly viscous yellowish effusion containing eosinophils and immunoglobulin E (IgE), eosinophil chemoattractants, such as eosinophil cationic protein, interleukin-5, and eotaxin. Local sensitization against foreign agents such as fungi or bacteria (e.g., Staphylococcus aureus) may result in local IgE production in the middle ear and may be responsible for the severity of EOM. The clinical features of EOM closely resemble localized eosinophilic granulomatosis polyangiitis, therefore it is necessary to be vigilant to the symptoms of mononeuritis, polyneuritis, and skin purpura during diagnosis. Standard treatment for EOM is the instillation of triamcinolone acetonide into the mesotympanum. However, severe cases exhibiting strong inflammation and otorrhea are not easily controlled with antibiotics and/or corticosteroids. We proposed the introduction of a severity score to evaluate the severity of EOM. This score correlated with local IgE levels in middle ear effusion. Clinically, the risk factors associated with this severity score were body mass index, and the duration of bronchial asthma (from the onset of BA to the age of the first consultation of otitis media to our hospital). We emphasize that early diagnosis and adequate treatment are vital in preventing progressive and sudden hearing loss resulting from EOM.

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Authors and Affiliations

  1. Department of Otolaryngology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma, Omiya-ku, Saitama, 330-8503, Japan

    Hiromi Kanazawa & Naohiro Yoshida

  2. Department of Otolaryngology, Tokyo-Kita Medical Center, Tokyo, Japan

    Yukiko Iino

Authors
  1. Hiromi Kanazawa
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  2. Naohiro Yoshida
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  3. Yukiko Iino
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Correspondence to Hiromi Kanazawa.

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Drs. Kanazawa, Yoshida, and Iino declare no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Otitis

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Kanazawa, H., Yoshida, N. & Iino, Y. New Insights into Eosinophilic Otitis Media. Curr Allergy Asthma Rep 15, 76 (2015). https://doi.org/10.1007/s11882-015-0577-2

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  • DOI: https://doi.org/10.1007/s11882-015-0577-2

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