title: Risk factors associated with severity of eosinophilic otitis media.
abstract: OBJECTIVE
  Eosinophilic otitis media (EOM) is an intractable otitis media associated with bronchial asthma. Clinical characteristics of EOM are apparent, but severe EOM, which is unresponsive to ongoing treatments, can occur. The present study aimed to investigate potential risk factors associated with the severity of EOM.
  
  
  METHODS
  We scored the EOM severity of 26 patients according to quantity of middle ear effusion (MEE), thickness of the middle ear mucosa, use of topical and oral corticosteroids, and use of antibiotics, all measured over a 3-month period. The scores for four 3-month periods (1 year) were averaged. We analyzed the prevalence of clinical variables by partial regression: sex, age, body mass index (BMI), duration of bronchial asthma, association of aspirin-intolerant asthma, Lund-Mackay score for sinusitis, mastoid pneumatization, width of the bony Eustachian tube at the tympanic orifice, percentage of eosinophils and immunoglobulin E in peripheral blood, and association of allergic rhinitis. Duration of bronchial asthma was defined as the period from onset of bronchial asthma to the age of first consultation at our hospital. Samples of MEE were taken for bacterial culture.
  
  
  RESULTS
  The average severity score was 6.6 (out of 16). The severity score in the pathogen-positive MEE group was significantly higher than that in the pathogen-negative MEE group (p<0.05). The score was not significantly different between the seasons. Linear multiple regression analysis showed that BMI and the duration of bronchial asthma significantly affected the EOM severity score (p<0.05). The presence of aspirin intolerant asthma tended to be correlated with the severity score. The Lund-Mackay score tended to be negatively correlated with it.
  
  
  CONCLUSIONS
  There is a significant association between the severity of EOM and obesity, as well as with the duration of bronchial asthma.
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan. Electronic address: hkanazawa@jichi.ac.jp.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kanazawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Yoshida
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Hara
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Matsuzawa
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shinnabe
authors.affiliation: Department of Otolaryngology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Iino
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications*; D004802:Eosinophilia / Q000150:complications*; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy; D010034:Otitis Media with Effusion / Q000150:complications* / Q000188:drug therapy; D012044:Regression Analysis; D065631:Rhinitis, Allergic / Q000150:complications; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007073:Immunoglobulin E
keywords: Bronchial asthma; Eosinophilic otitis media; Obesity; Severity score