Seo Yukako, Nonaka Manabu, Pawankar Ruby
Department of Otolaryngology, Tokyo Women's Medical University.
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Curr Opin Allergy Clin Immunol. 2020 Feb;20(1):9-13. doi: 10.1097/ACI.0000000000000589.
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.
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.
EOM and asthma are closely related. Optimal asthma treatment is important for treating EOM. Treatments commensurate with the severity of EOM are being developed.
嗜酸性粒细胞性中耳炎(EOM)是一种难治性中耳炎,其特征是大量嗜酸性粒细胞浸润中耳腔,中耳腔是上呼吸道的一部分。EOM与哮喘的合并率很高。它们被认为存在“一个气道,一种疾病”的关系。在此,我们总结目前关于EOM的特征、EOM与哮喘的关系以及EOM最佳治疗效果的相关知识。
哮喘病情越严重,EOM的发展就越明显。在发生EOM的哮喘患者中,哮喘控制通常不充分,适当加强哮喘吸入治疗可使EOM得到改善。EOM的严重程度可分为轻度、中度和重度。使用曲安奈德等局部类固醇进行鼓室内灌注治疗对轻度EOM有效,而中度EOM除曲安奈德外还需要全身使用类固醇,重度EOM会形成肉芽组织,需要手术切除。最近,有分子靶向药物有效性的报道,但需要积累更多数据。
EOM与哮喘密切相关。最佳的哮喘治疗对EOM的治疗很重要。正在开发与EOM严重程度相适应的治疗方法。