Clinical findings of eosinophilic otitis media

Abstract

Objectives: Eosinophilic otitis media is a new entity representing intractable otitis media with viscous middle ear discharge containing eosinophils. However, the etiological background remains to be obscure. Aiming at an assessment of the clinical findings, cases of the eosinophilic otitis media at the outpatient clinics in Kyushu University Hospital were retrospectively reviewed. Methods: When middle ear discharge of patients with a complaint of intractable otorrhea and hearing loss was viscous, an infiltration of eosinophils into otorrhea was examined. In case of positive findings, further assessment was performed. Results: There were 5 males and 9 females, ranging in age from 38 to 70 years (average, 53) old; 71% were affected in bilateral ear. Allergic diseases, such as bronchial asthma, pulmonary eosinophilic infiltration and nasal polyp was complicated at 79%, 14%, and 43% of all patients, respectively. The blood eosinophil increased. Total serum IgE level was within normal range except one. RAST showed positive in 6. In contrast to the eosinophilic nasal polyp, eosinophilic infiltration in middle ear mucosa was not observed in 5 of 7 specimens. Aural polyp formation has a significant correlation to an initial onset age and neither blood eosinophil count nor illness period. Conclusion: Elevation of eosinophils in blood, no specific serum IgE, and middle ear antigen indicated that eosinophilic otitis media is one of the eosinophil-related disease. Aural polyp formation is not related to an infiltration of eosinophils like eosinophilic nasal polyp.