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[Eosinophilic otitis media]
Anne-Sophie Homøe1, Kasper Aanæs1, Jens Tidemandsen1
1Afdeling for ~re-Næse-Halskirurgi og Audiologi, Københavns Universitetshospital - Rigshospitalet.
Abstract:
Eosinophilic otitis media (EOM) is a rare, treatment-resistant middle ear condition characterised by eosinophilic secretions and a risk of irreversible hearing loss. The condition is often seen in patients with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) and is driven by type-2 inflammation. We describe two patients in this case with severe EOM and concomitant asthma and CRSwNP, in whom conventional treatment had limited efficacy. Treatment with the IL-5 inhibitor mepolizumab resulted in marked improvement in ear symptoms, improved hearing, and reduced need for systemic steroids.
Insights
Eosinophilic otitis media (EOM), a rare ear condition, often co-occurs with asthma and CRSwNP. Mepolizumab treatment significantly improved symptoms and hearing in two patients with severe EOM.
Area of Science:
- Otolaryngology
- Immunology
- Allergy
Background:
- Eosinophilic otitis media (EOM) is a rare, severe middle ear disease.
- EOM is characterized by eosinophilic secretions and can lead to irreversible hearing loss.
- It is frequently associated with asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), driven by type-2 inflammation.
Purpose of the Study:
- To report the efficacy of mepolizumab in treating severe EOM.
- To evaluate the impact of IL-5 inhibition on EOM symptoms and hearing.
- To assess the potential of targeted therapy in patients with coexisting asthma and CRSwNP.
Main Methods:
- Case report of two patients with severe EOM, asthma, and CRSwNP.
- Patients received treatment with mepolizumab, an IL-5 inhibitor.
- Outcomes assessed included ear symptoms, hearing levels, and systemic steroid requirements.
Main Results:
- Mepolizumab treatment led to significant improvement in ear symptoms.
- Patients experienced enhanced hearing following treatment.
- The need for systemic steroid therapy was reduced.
Conclusions:
- Mepolizumab is a promising therapeutic option for severe EOM, particularly in patients with comorbid asthma and CRSwNP.
- Targeting IL-5 may effectively manage EOM by addressing the underlying type-2 inflammation.
- Further research is warranted to confirm these findings in larger cohorts.
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