Subtotal petrosectomy and cochlear implantation for severe eosinophilic otitis media with infection: A case report

Eosinophilic otitis media (EOM) is an intractable otitis media characterized by highly viscous secretions containing eosinophils in the middle ear. Clinically, bacterial infection complicates the course of EOM and may accelerate the progression of sensorineural hearing loss. We present a case of a woman in her late 50s, diagnosed with severe EOM, experienced recurrent ear infections despite repeated tympanostomy tube insertions, intratympanic corticosteroid injections, and systemic corticosteroid treatment. Microbiological analysis of middle ear effusion revealed methicillin-resistant Staphylococcus aureus and Candida parapsilosis coinfection. The use of corticosteroid and biologic agents was contraindicated due to the active infectious process. The patient underwent surgical debridement by subtotal petrosectomy, and obtained a successful infection control. Following resolution of the infectious process, the patient with bilateral severe mixed hearing loss and inadequate benefit from conventional hearing aids underwent successful cochlear implantation (CI), achieving satisfactory auditory rehabilitation. In cases of severe EOM complicated by refractory infections, subtotal petrosectomy represents a potentially effective therapeutic strategy for infection control and disease progression mitigation. Subsequent CI may be considered as a viable option for auditory rehabilitation in selected cases.