title: Eosinophilic inflammation in the middle ear induces deterioration of bone-conduction hearing level in patients with eosinophilic otitis media.
abstract: OBJECTIVE
  Eosinophilic otitis media (EOM) is characterized by the extensive accumulation of eosinophils in the middle ear mucosa and middle ear effusion and is usually associated with bronchial asthma. Eosinophilic otitis media patients show gradual or sudden deterioration of hearing. In our previous study, we reported that high-tone loss was more frequently found and more severe in EOM patients than in control patients with chronic otitis media. These findings suggest that not only bacterial infection but also eosinophilic inflammation in the middle ear may damage the inner ear. The present study was performed to determine whether eosinophilic inflammation is indeed related to deterioration of bone-conduction hearing level (BCHL).
  
  
  METHODS
  Fifty-five ears of 28 patients with EOM associated with bronchial asthma were included in this study. Middle ear effusion (MEE) samples were collected from all the patients, and the concentrations of eosinophilic cationic protein (ECP) and immunoglobulin E (IgE) were measured by fluorescence enzyme immunoassay. The BCHLs at 2 and 4 kHz for the worse-hearing ear of each patient were correlated with the concentrations of ECP and IgE.
  
  
  RESULTS
  The concentration of IgE in MEE significantly and positively correlated with BCHL at 2 and 4 kHz. The ears with a higher concentration of ECP in MEE also tended to show deterioration of BCHL at 4 kHz. Other clinical risk factors for BCHL deterioration were male sex, long duration of EOM, association with bacterial infection, severe inflammatory changes of the middle ear mucosa, and high serum IgE concentration.
  
  
  CONCLUSIONS
  Eosinophilic-inflammation-related substances such as ECP and IgE are closely related to the deterioration of BCHL at high frequencies. Particularly, IgE concentration in MEE is a good indicator of BCHL elevation. We should always pay attention to the hearing acuity of EOM patients with the risk factors.
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan. yiino@jichi.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
authors.forename: Hajime
authors.initials: H
authors.lastname: Usubuchi
authors.forename: Kozue
authors.initials: K
authors.lastname: Kodama
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.forename: Katsumi
authors.initials: K
authors.lastname: Takizawa
authors.forename: Takeharu
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D002908:Chronic Disease; D047150:Eosinophil Cationic Protein / Q000032:analysis; D004804:Eosinophils / Q000378:metabolism*; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D034381:Hearing Loss / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007118:Immunoassay; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000150:complications* / Q000378:metabolism; D012044:Regression Analysis; D012720:Severity of Illness Index
chemical_list: D007073:Immunoglobulin E; D047150:Eosinophil Cationic Protein