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Published on: August 25, 2020
Eosinophilic otitis media and comorbid asthma
Yukako Seo1, Manabu Nonaka1, Ruby Pawankar2
1Department of Otolaryngology, Tokyo Women's Medical University.
Purpose Of Review:
Eosinophilic otitis media (EOM) is an intractable otitis media characterized by numerous eosinophils infiltrating the middle ear cavity, which is part of the upper airway. EOM shows a high rate of comorbidity with asthma. They are considered to have a 'one airway, one disease' relationship. Here, we summarize our current knowledge regarding the characteristics of EOM, EOM's relationship with asthma and the efficacy of optimal treatments for EOM.
Recent Findings:
The greater the severity of asthma, the more pronounced the development of EOM. Asthma control is usually inadequate in asthmatics who develop EOM, and appropriate strengthening of asthma inhalation therapy leads to improvement in the EOM. EOM severity can be divided into mild, moderate, and severe. Intratympanic infusion therapy using a topical steroid such as triamcinolone acetone is effective for mild EOM, whereas moderate EOM requires a systemic steroid in addition to triamcinolone acetone, and severe EOM forms granulation tissue that requires surgical removal. Recently, the effectiveness of molecularly targeted drugs is being reported, but more data need to be accumulated.
Summary:
EOM and asthma are closely related. Optimal asthma treatment is important for treating EOM. Treatments commensurate with the severity of EOM are being developed.
Insights
Eosinophilic otitis media (EOM), linked to asthma, requires tailored treatments. Effective management involves controlling asthma and using therapies specific to EOM severity, from topical steroids to surgery.
Area of Science:
- Otolaryngology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Eosinophilic otitis media (EOM) is a severe middle ear inflammation with significant eosinophil infiltration.
- EOM frequently co-occurs with asthma, suggesting a shared pathophysiology under the 'one airway, one disease' concept.
Purpose of the Study:
- To review the characteristics of EOM.
- To explore the relationship between EOM and asthma.
- To evaluate the efficacy of current EOM treatments.
Main Methods:
- Literature review summarizing current knowledge on EOM.
- Analysis of the correlation between asthma severity and EOM development.
- Assessment of treatment strategies based on EOM severity.
Main Results:
- Asthma severity directly correlates with EOM development; inadequate asthma control exacerbates EOM.
- Topical steroids are effective for mild EOM, while moderate cases require systemic steroids.
- Severe EOM with granulation tissue may necessitate surgical intervention; targeted therapies are under investigation.
Conclusions:
- EOM and asthma share a strong etiological link.
- Optimizing asthma management is crucial for effective EOM treatment.
- Treatment approaches for EOM must be individualized according to disease severity.
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