Breslin Nathaniel K, Heindel N Hadley, Haberman Rex S
College of Medicine, University of Florida, Gainesville, Florida, USA.
Department of Otolaryngology, University of Florida, Gainesville, Florida, USA.
OTO Open. 2021 Feb 2;5(1):2473974X21991449. doi: 10.1177/2473974X21991449. eCollection 2021 Jan-Mar.
Eosinophilic otitis media (EOM) is a rare form of middle ear disease characterized by a viscous effusion rich in eosinophils, a resistance to conventional treatments, and an association with bronchial asthma. The relationship between asthma and EOM suggests similarities in pathogenesis and treatment possibilities. Recent biologic therapies, specifically those that target interleukin 5 (IL-5), have demonstrated efficacy in controlling eosinophil-driven asthma, yet their impact on the treatment of pathologically similar diseases remains unmeasured. This study identifies patients who have EOM, reviews their otologic clinical course, and investigates the impact of anti-IL-5 drugs on chronic ear disease.
Retrospective chart review.
University of Florida Health, an academic medical center.
A review of 120 patients treated with benralizumab or mepolizumab was performed. Imaging evidence of otomastoiditis was used to identify 9 patients with possible EOM. Two patients were treated with benralizumab, and the remaining 7 received mepolizumab injections.
After starting treatment, 5 patients had complete resolution of middle ear effusions (3 with mepolizumab and 2 with benralizumab); 1 had stable middle ear effusion; and 1 patient's disease status could not be determined due to a lack of follow-up. The remaining 2 patients did not have effusions at the time when anti-IL-5 therapy was initiated, and they have not relapsed since starting treatment.
EOM is a rare disease that otolaryngologists should include in their differential diagnosis, especially in refractory cases. Anti-IL-5 agents show efficacy in treating EOM, and prospective multicenter clinical trials are needed to further characterize the effect of anti-IL-5 therapies.
嗜酸性粒细胞性中耳炎（EOM）是一种罕见的中耳疾病，其特征为富含嗜酸性粒细胞的黏稠积液、对传统治疗有抵抗性且与支气管哮喘相关。哮喘与EOM之间的关系提示了发病机制和治疗可能性方面的相似性。近期的生物疗法，特别是那些靶向白细胞介素5（IL-5）的疗法，已证明在控制嗜酸性粒细胞驱动的哮喘方面有效，但它们对病理上相似疾病治疗的影响仍未得到评估。本研究识别患有EOM的患者，回顾其耳科临床病程，并研究抗IL-5药物对慢性耳部疾病的影响。
回顾性病历审查。
学术医疗中心佛罗里达大学健康中心。
对120例接受贝那利珠单抗或美泊利珠单抗治疗的患者进行了回顾。利用耳乳突炎的影像学证据识别出9例可能患有EOM的患者。2例患者接受了贝那利珠单抗治疗，其余7例接受了美泊利珠单抗注射。
开始治疗后，5例患者中耳积液完全消退（3例使用美泊利珠单抗，2例使用贝那利珠单抗）；1例患者中耳积液稳定；1例患者因缺乏随访无法确定疾病状态。其余2例患者在开始抗IL-5治疗时没有积液，自开始治疗后未复发。
EOM是一种罕见疾病，耳鼻喉科医生应将其纳入鉴别诊断，尤其是在难治性病例中。抗IL-5药物在治疗EOM方面显示出疗效，需要进行前瞻性多中心临床试验以进一步明确抗IL-5疗法的效果。
